Three Secrets to Running a Successful Cash Practice (S1E3)

Hello and welcome to the Cash Practice Solution podcast. I’m your host, Dr. J, and today we’re going to get into the three simple secrets for a successful cash practice. So whether you’re a seasoned practitioner or just starting out and considering making the switch to a cash-based model, this episode is for you.  If you want to maximize your cash practice or start out on the right foot, you need to check out our cash practice scorecard. It’ll help you make all the right decisions from the very start. It’s linked in the description at cashpracticesolution.com. Let’s get started.  

Step 1 – Burn the Ships and Don’t Look Back

So there’s this great song and the line is, “Come on, just light the match and turn and watch the ships burn”. I love the song, and these lyrics are from Jake Scott’s song Ships of Cortez. I mean, it just hits me right in the heart. If you consider the transition to a cash practice, you have to do that. It’s about fearlessly letting go of the past and embracing the somewhat unknown. We’ll help you with that somewhat unknown – We’ll make it a lot better known. Moving from a third-party, dependent practice to a cash-based model isn’t just about changing your billing system or your front office behavior. It’s about reclaiming your freedom and reigniting your passion for medicine   The frustrations of dealing with insurance companies, legislatures, and regulators can dampen anybody’s professional spirit, just everything about it. It just wears you out. But, there’s hope when you embrace a cash practice. You take back control of your career and rediscover the joy that led you to medicine in the first place.  Imagine walking away from those unbelievably painful, long days of filling out forms and checking boxes, with no more third-party masters to please. Instead, you’re free to practice medicine on your own terms. And let me tell you, this freedom is not a mirage. I live it. It’s a reality.  I can remember being trapped in the insurance nightmare myself. Seeking advice from a few successful third-party free doctors became my lifeline. Their counsel was precious to me – with strategies that maybe were different than the insurance company model, and then doing it without the safety net of insurance payments. It was priceless. Knowing that I wasn’t alone gave me the confidence to move forward. For more information visit www.FEMA.gov, and then there was the IT independence practice. but the business practice was very successful. It was being done. One of my colleagues in Dallas even suggested, God forbid, that I close my practice and open a new one entirely – close the doors, shut down the building, and open a whole new building. He said people won’t be confused with a little this, a little of that. And my patients would be much better as I transitioned away from the insurance-based practice. I thought it was nuts, that’s crazy But (crazy or not), he took his own advice and now he’s got this incredible, swanky place on the beach in Southern California. And, his unbelievable success in regenerative medicine – it speaks for itself. He’s just a rock star. So, step one: light the match, turn, watch the ships burn, and don’t look back.  It’s the only way to go. You gotta let it go.  

Step 2 – Focus on your Doctor-Patient Relationship

So, since we’re on the subject of cool songs, in 1991, Randy Travis wrote a totally amazing song, The Better Class of Losers, which is totally fun. The lyrics – they’re about it’s authenticity that matters, not appearance. As a doctor, it’s you being everything that you can be for a patient and not the appearance of things. In the context of your practice, it means that patients care more about your investment in their care than a fancy office. Like the old saying, “They, want to know how much you care than care about how much you know.” So when I first started, I was seeing patients in a spare room off the driveway in a little suburban house in Texas. It was cool for a while. I was busy. I had other things to do. I had a side gig and all that. Demand grew and it became very clear that I would need a more professional space than something off the garage. Word of mouth was spreading (which, by the way, is the number one Marketing tool that there is), and soon enough, I was getting calls from patients I’d never met, and seeing them at my house. My personal residence wasn’t an option because I don’t know who that would be. So it was time to get creative and I started looking for office spaces but nothing was exactly what I wanted. It didn’t fit my criteria, and I kind of needed these things:

• I needed something close to home, real easy access so you could kind of jump out of your car and go. 
• I needed enough space for a little reception area. It’s nice.
• I needed a treatment room That’s all I needed – one treatment room because I wanted to take time 
• I wanted a short-term lease and no long-term commitment, which understandably, is difficult to find. 

So after some searching, I found the perfect solution. One of my wife’s friends was married to a chiropractor named Daryl. He had a really nice office space near our home. and he wasn’t using it on Tuesdays and Thursdays until 2 p.m. His wife was actually a designer. So, it was pretty nicely done and we struck a deal. He let me use the space when he wasn’t there, and in return, I would act as his Medical Director and help with the patients who needed treatment that was outside of his scope (He couldn’t prescribe medicines.). It was a win-win. It allowed me to grow my practice in a professional setting that was attractive.  Without any kind of commitment, I could come and go. He put my name on the door so that he had a Medical Director, which was great with me. But, quickly (after a year), I outgrew the space. From the little house, to this little chiropractic office that I was sharing, I outgrew them both. Next, I had a very, very skilled physical therapist who was a friend; and he and I partnered together to open a significantly larger office. You need to know – despite the fears that we talked about before, cash practices tend to grow very quickly when you’re committed to listening to your patients, learning their stories, and loving them up. Before long, I moved into my current 4,000-square-foot space (which we use every square inch of), and we’re very, very busy. Remember, when patients want your care, that’s what they want. They don’t want the fancy flowers and decor as much as they want your care. Remember the old saying: “They want to know that you care more than care what you know”. So, be resourceful. prioritize relationship over appearance – that’s step two. 

Step 3 – Love Your Patients

Finally (my age is showing), the Beatles song “All You Need is Love” – It’s a timeless truth for life in general, but especially for building a successful cash practice. Patients want to be known and loved. It’s more than a feeling. It’s not a romantic thing or anything like that. It’s a decision that you make every day as a practitioner – commitment to your patient really is what it’s about.  Love is a commitment when patients ask, “What would you do if this was your mom or your dad or your best friend?”. They’re asking for the reassurance that you care about them on a very personal level. They want to know they’re not just another number or a case, but someone that you really care about. The doctor-patient relationship is at the heart of quality health care. I mean, it’s it’s the nub that everything runs on. It requires time, interaction, and understanding. When you know your patients, you can care for them in a way that transcends all other clinical treatment; and that deep connection that is formed is the foundation of trust and healing.  All those beautiful thoughts are a solid philosophical root that produces an incredibly loyal patient base that provides you with a very, very good successful practice, financially. So, practicing medicine in this way requires commitment. The world is full of distractions and demands, and it’s easy to lose sight of what’s important. But if you keep the patient at the center of the decision, you’ll find that your practice thrives. Patients will flourish in an environment where they’re loved and cared for.  This is a really good story. Dr. Abraham Hofer (who was kind of a sort of hippie-sort of doctor, I guess). He worked in the mental health field as a psychiatrist, and nobody thought that nutrition was a big deal. He was a hero in that world. He had a schizophrenic son who he treated with niacin, and his son recovered, and he said that nutrition was very important. Science was very important. But his number one criterion for psychiatric recovery was that a loving home life was the number one factor for recovery.  Your medical practice can be that medical home for that patient’s loving home-life. It can be that way. In a cash practice model, you can take as much time as you [and the patient] need. That’s a relationship between you and the patient that you work out, and if they’re okay with what you charge them for an hour of your time, you spend an hour. If you can’t spend that much time, you do the best you can in the time they can afford, and that’s very acceptable. In today’s chaotic world, that loving doctor-patient relationship is their safe harbor. If you think gold is quite a commodity, try to find love at a doctor’s office. But, you can be that practice. You can do that. You’ll have time. So, listening to your patients, learning their story, and loving them – that is the key to a thriving practice. Anything that interferes with your ability to invest in your patient’s care is toxic to that relationship.  To be honest, insurance companies – they’re not measuring the value of love and dedication. That’s not on the scorecard That’s not on their check sheet. That’s not in the paperwork that you’re filling out for MIPS. That’s not it. But, your patient understands it, and that’s why the transaction and cash practice should be that natural extension of the love and care that you provide (instead of a third party getting in there). They can’t understand it. They don’t know what it is.  So the third and final secret? You Love your patients. Invest in them, and you will find referrals. You can get whatever contact resource management tool you want, but nothing works like loving your patients.   o that wraps up today’s episode of the Cash Practice Solution Podcast. I hope these three simple steps inspire you to take the leap into a cash-based practice, or strengthen one you already have. Remember, light the match, and don’t look back. Be resourceful. And most importantly, lead with love.   If you want more tips and resources, visit us at cashpracticesolution.com where we offer white papers, technology, and a tremendous team to help you succeed. And remember, if you want to maximize your cash practice to start out on the right foot, check out the cash practice scorecard. It’ll help you make all the right decisions from the start. It’s linked on that website. I’m Dr. J., and I am excited to share next time – the top five mistakes I made when starting my cash practice. Until then, listen to your patients, learn their story, and love them. You will be unstoppable.