Handbook of Concierge Medical Practice Design

v

Contents

Foreword .......................................................................................... xi

Preface ............................................................................................ xiii

About the Author ........................................................................... xvii

1 Private Practice in Transition ......................................................1

Introduction .................................................................................................1

The Exciting New World of Medical Practice .....................................1

The Disruption of the Traditional Private Medical Practice in

America ................................................................................................2

Concierge Medicine ....................................................................................3

Direct Practice .............................................................................................5

Corporate Concierge Medicine ...................................................................6

The Patient- Centered Medical Home .........................................................8

Accreditation and Practice Management for the Private Medical

Practice of Tomorrow ...............................................................................10

NCQA Scoring Criteria for Patient- Centered Medical Homes ..........10

Standard 1: Access and Communication—9 Possible Points ...10

Standard 2: Patient Tracking and Registry Functions—

21 Possible Points ......................................................................11

Standard 3: Care Management—20 Possible Points .................11

Standard 4: Patient Self- Management Support—6 Possible

Points ..........................................................................................11

Standard 5: Electronic Prescribing—8 Possible Points .............11

Standard 6: Test Tracking—13 Possible Points .........................12

Standard 7: Referral Tracking—4 Possible Points .....................12

Standard 8: Performance Reporting and Improvement—

15 Possible Points ......................................................................12

Standard 9: Advanced Electronic Communications—

4 Possible Points ........................................................................12

vi ◾ Contents

Welcome to the Disruptors’ World ....................................................14

Physician Entrepreneurship ...............................................................14

Building the Practice of Your Dreams .....................................................16

What Skills Will You Need? ......................................................................17

Marshalling the Courage and Skills to Transform Your Medical Practice ... 18

Reinventing Private Practice......................................................................19

Get Mobilized ............................................................................................28

Attributes of a Successful Concierge Physician ........................................29

2 Frequently Asked Questions ...................................................... 31

Evaluating the Advisors and Trends .........................................................32

Learn How to Evaluate and Hire Professional Advice ............................. 37

3 Turning Crisis into Opportunity ...............................................39

4 Determining If You Are Ready to Enter Concierge Medicine ....41

Financial Readiness ...................................................................................41

Strategic Readiness ....................................................................................42

Your Current Brand Reputation ................................................................43

Will You Be Converting an Existing Practice? .........................................44

Your Resources and Assets .......................................................................46

Exercise 1: Setting the Vision for Your New Practice ..............................47

Exercise 2: Determining Your Comfort with Business Ownership ......... 49

5 What Sets You Apart from Other Concierge Physicians?...........53

How to Describe Your New Business Model ..........................................54

Developing a Market Niche within Your Specialty .................................. 55

Exercise 1: Market Niche Data Collection ................................................56

Exercise 2: Choosing Your Market Niche .................................................58

Turning Your Chosen Market Niche into Something Marketable ............60

Building the Expertise in Your Market Niche ..........................................63

Building Additional Expertise ...........................................................65

Building Influence as a Medical Expert in Your Market Niche

Domain Area ............................................................................................. 67

Using Your Power and Influence ...................................................... 73

6 Clarifying Your Business Concept: Welcome to the Next

Chapter of Your Professional Life ..............................................77

Working with Consultants and Contractors to Get You Started ..............77

The Difference between a Concierge Medicine Product and Medical

Services ...................................................................................................... 79

A Consultant Should Never Assume What You Want ......................88

Contents ◾ vii

Exercise 1: Goal Setting ............................................................................89

Exercise 2: Business Priorities ..................................................................90

Exercise 3: Motivating Factors ..................................................................91

Exercise 4: Articulating My Business Values ............................................92

Exercise 5: My Role Models—Who Do I Admire? ...................................93

Exercise 6: Identifying That Which Excites You about Your

Concierge Medicine Practice Idea ............................................................93

Exercise 7: Your Business Concept ..........................................................94

Exercise 8: Testing Market Preferences for Your Concierge

Amenities Package & Price Point .............................................................97

How to Gather Data without a Melee ..............................................97

What to Do after the Decision to Move Forward ............................98

Defining Your Strategic Position: What Business Are You In? Really? ....98

Review of Chapter6: Startup Considerations ........................................100

7 Creating Your Practice Identity ...............................................103

Creating Your Identity .............................................................................103

Your Identity Is Your Brand Image, Not Your Brand ............................103

Integrated Marketing Communications ..................................................105

Be Efficient and Run a Lean Shop .........................................................105

Finding Unbiased Guidance ...................................................................105

Accountability and Measurement of Marketing ROI .............................. 106

Web Analytics .........................................................................................106

Key Considerations for Choosing a Name ......................................107

Exercise 1: Business Naming Exercise ...................................................108

Protecting Your Trademarks and Service Marks .................................... 109

Exercise 2: Developing Your Creative Brief ........................................... 110

8 Getting Organized ...................................................................113

Setting Up Physical and Digital Files ...................................................... 114

Set Up Digital Utilities ............................................................................. 115

Set Up Survey Monkey (for CAHPS Surveys) ......................................... 115

9 Business Intelligence for the Concierge Medical Practice ....... 117

Exercise 1: Analysis of Competitors ....................................................... 117

Public Relations ....................................................................................... 121

The Importance of Community ..............................................................121

The Importance of Associations and Societies ...................................... 121

Exercise 2: Community Events and Speaking and Public Relations

Opportunities ..........................................................................................122

viii ◾ Contents

10 Startup Red Tape .....................................................................125

Legal Counsel .......................................................................................... 125

Exercise 1: Medical Practice Startup Red Tape ......................................127

11 Team Building .........................................................................129

Human Resources Loose Ends ...............................................................129

12 Operations and Practice Management .....................................133

Practice Administration versus Practice Management ...........................133

Finding a Location for Your Concierge Medical Practice ......................135

Deciding on the Attributes of Your New Concierge Medical Practice

Location ...................................................................................................136

Contemporary Advancements and Evidence- Based Design ..................140

Radiology ......................................................................................... 143

Laboratory ........................................................................................144

Pharmacy/ Dispensary .....................................................................144

Natural Disasters..............................................................................144

Floors ............................................................................................... 145

Ceilings ............................................................................................ 145

Interior Doors .................................................................................. 145

Door Swings ....................................................................................146

Safety Glazing ..................................................................................146

Stairways ..........................................................................................146

Wall Protection at Drinking Fountains and Lavatories .................. 147

Medical Waste .................................................................................. 147

General Waste ................................................................................. 147

Recycling .......................................................................................... 147

Soiled Linen ..................................................................................... 147

Medical Records ..............................................................................148

Space Rental Considerations ...........................................................148

13 Designing the Layout of Your New Concierge Practice ........... 153

Exercise 1: Practice Layout Consideration .............................................. 158

Exercise 2: Floor Plan Layout .................................................................160

Exercise 3: Designing Your Operations Processes and Evaluating

Your Costs ............................................................................................... 161

14 Planning the Move to Your New Concierge Medical Practice

Location ...................................................................................163

Should You Purchase or Lease? ..............................................................164

Exercise 1: Warranties and Service Contracts to Manage ...................... 168