Handbook of Concierge Medical Practice Design

77

Chapter 6

Clarifying Your Business

Concept: Welcome

to the Next Chapter

of Your Professional Life

Starting a business is exciting! So often, we receive calls from physicians

who are frustrated with what has become of healthcare, their career, their

practice revenues and overheads, and their work– life balance. If you have

already decided to launch a concierge or direct practice, all that is about to

change for you.

In the previous chapters, we worked on the ideal practice vision, what

you want it to be, and we worked on some introspective insights and your

reason for taking this step, and what you hope to achieve through expert

power, influence, and charisma.

Working with Consultants and Contractors

to Get You Started

This next section is not meant to be self- serving, by any means. I included

it because it is highly likely that you will ask several consultants (lawyers,

accountants, and other specialized consultants) for help and guidance. You

have to know how to best work with a consultant, or you might be taken

78 ◾ Handbook of Concierge Medical Practice Design

advantage of by those who sell good words, but have only greed as a goal,

preying on the rich doctors who have more money than sense.

You may not be all that familiar with how consultants and contractors

can play a role to help you clarify and execute your business concept. If

the people you plan to hire to help you clarify your business concept are

incapable of writing or discussing what I covered in Chapter5, at the level

of knowledge of how concierge medicine works and what it takes to dif-

ferentiate your concierge brand, think hard about whether you want them

guiding anything else about your business.

There are a small number of good consultants who specialize in develop-

ing this kind of a practice. They are available to assist you and be supportive

like a business startup Sherpa. Your consultants’ roles are to act as a guide

to facilitate your journey across the mountain peaks you are about to negoti-

ate in the development of your business.

If you outsource certain tasks, that is the role of a contractor, not a con-

sultant. The two are very different. If you jumped to this section of the book

without reading the previous chapters, you missed my view on the differ-

ence between consultants and contractors. One advises about things, and

helps you make decisions by calling on professional training and experience.

The other does things by the hour. Consultants sometimes direct the work

of contractors or help you design the scope of work that the contractor will

do for you. Knowing the difference between the two can save you time and

money and avoid costly mistakes and poor guidance.

In our firm, we employ both consultants and contractors. In addition to

guiding you and providing instruction and insight, if you get tired, over-

whelmed, can’t manage something, or simply don’t want to do a task, you

can hand it over to us for assistance. Not all firms do this, and some who

do it charge the same for contract assistance as they do for consulting. This

is not in your best interest. Consultants charge for their knowledge and

expertise. Contractors should be paid mid- market to top- market rate for the

job they are doing, plus about 40–45% to cover margins, overheads, and

expenses usually paid by an employer.

Contractors work on a deliverable or a list of deliverables, produced in

a certain time frame. They work by a specification called a scope of work

(SOW). They are often not paid on retainer, but instead hired by the hour or

the project. They may ask for a deposit and tranche funding (paid in time

increments or at project milestones). In most cases, you will be charged for

any expenses incurred or paid out on your behalf.