Attracting the Right Patients for Your Cash Practice (S1E6)

Welcome back to the Cash Practice Solution, where we focus on your quality practice and making sure you get properly compensated for the work you do. I’m your host, Dr. J, and today we’re discussing a pivotal aspect of practice management: defining your ideal patient.  This is critical for creating the meaningful connections you need to drive your practice’s success.

Defining the Ideal Patient

In the business world, the ideal patient is called an ICP – the Ideal Client Profile. Let’s paint a picture of the practice guaranteed to struggle (I completely understand this. It was me at the beginning of my career). I just finished internship training, and the training hospital asked me to help them get a satellite clinic started in a neighborhood nearby.

Opening My Cash Practice

I enthusiastically embraced their consultants because what did I know? I didn’t know anything. So I opened my first practice, full of optimism – “I’m going to take on everybody, and I’ll serve anyone who walks through the door.” At first, I thought that the “more patients equals success” mindset was right, but it didn’t take long for reality to set in. I felt like I was moonlighting in somebody else’s urgent care (I knew this feeling from previous moonlighting, gigs). Except, now it was my practice. We were busy, but not seeing the type of patient that gave me life. I was becoming weary of generic interactions with patients who were not invested in the type of healthcare that I wanted to provide. Most of them wanted the quick and dirty “I just needed a prescription” style of medicine, and that is not what I was looking for. I wanted to be more involved in their care and really provide some things that they couldn’t necessarily get somewhere else. I wanted to have a relationship with my patients and hear their stories. I never considered what would an ideal patient look like (or even knew there was one), especially during medical training. Training doesn’t teach you to have patient relationships. You’re basically rolling through. When I stepped out into the hospital-sponsored satellite clinic, the whole practice was oriented toward feeding patients into the hospital. If you’re thinking about being an employed doctor, that’s what employed practice is like. You’re feeding the hospital. It’s all about numbers and volume. 

“Corporate Medicine Kills Relationships.”

Without a clear definition (for me) of an ideal patient, I ended up seeing all sorts of people with all kinds of expectations; and too many of them weren’t right for my style of practice. I knew within just a few months of practice this was not what I wanted for my patients. I wanted more for myself and more for them. Treating patients to satisfy the hospital admissions consumed so much time and energy, and neither the patients nor I received the kind of outcomes we all were looking for. I wanted people who were getting stronger, healthier, and better, not just running through prescriptions. The strong doctor-patient relationships were my ultimate goal, and I only knew how to build them with communication. I didn’t have the time I desired to spend with patients, and the consultants continued to recommend just increasing volume. I had to start to look to engage patients who were interested in the same kind of medical treatment I was interested in providing. What’s really crazy is that if you look at the literature and data from management studies, they show that a solid doctor-patient relationship makes patient retention increase by 30 percent, and patients who feel connected, like, “I really – I love my doctor” – they are 500 percent more likely to come back for future care. The ready-med and urgent care kind of environment – has its place and is a great “urgent” solution. We refer to them on weekends when the practice isn’t able to handle patients. They’re great to have, but it doesn’t compare to a deep and meaningful doctor-patient relationship.

Committing to the Ideal Patient and Job Satisfaction

When I finally committed to identifying my ideal patient profile, which was revolutionary. I started attracting patients who resonated with my philosophy and really wanted to engage in their care.  The impact of having ideal patients is absolutely profound.  Not only do they remain loyal, but they also refer other patients who are like them, with similar values and needs – fitness people, health-oriented people (people who want to go low on meds and do more natural stuff), which is more my groove in our practice. We can trace a huge percentage of our patients to just about maybe half a dozen, what I call super-referers. I would say half of our patients have stemmed from those half dozen people. We take really good care of them, and we make sure that they know we are on their team and have their best interest at the forefront of our care. Research shows that referred patients stay with the practice and have a much higher lifetime value in terms of total income revenue, way more than the non-referred patients. Studies show it’s at least 25 percent, and I believe it’s probably way higher. Traditional marketing cannot compete with word-of-mouth marketing. We have spent a bunch of money marketing throughout the years but it always results in the same thing, lost dollars, and very little benefit. Once you begin to develop a patient base that aligns with your ideals and practice style you will have a full-time referral source that only grows. It’s a snowball effect, and the quality of your practice brings more (and more, and more) of the same.

Selecting Characteristics for Your Ideal Patient

Let’s talk about how to select your ideal patient based on specific characteristics. Here are some key traits to consider. 

1. You want to look for values to be aligned. Find groups where there are patients who share your values and approach to healthcare. Find patients who want to develop communication and create cooperative treatment plans and practice-shared decision-making.
2.  Next, find patients who are proactive, and those who are motivated to be well. They don’t have to work out every day, but they have to be willing to consider it. I call it “Vitamin X”. I really want to coach patients to get into exercise (Vitamin X), and they need to take some responsibility for their care. I don’t need them to be perfect, but I want them to be willing to have the conversation and most patients if you coach them enough, they’re going to get there. They’re going to start to engage in some activity.
3. Demographically, you want to consider the patient’s age. Our patient’s age really is very clear to us – between 30 and 70 years old. That’s kind of the sweet spot. Some people need to consider location. We see patients from all over the country, so it’s not quite as important to us, but location can really matter.
4. Lifestyle Factors. People who eat Cheetos and Dr. Pepper for meals are not a good demographic for most people who are into wellness/fitness practice. Make sure that you understand the kind of demographic you’re looking for (Are they fit people, who are a certain age group?). Knowing these factors can really help with treatment history. One of the things with our technology that really helps us support our patients is when we do symptom assessments, we also do history assessments with this technology we can readily see a patient who has a history of really doing what the doctor ordered and having positive outcomes is almost sure to have the same relationship with you. They’ll do what you say, and they’ll generally do well.
5. ”Warning, warning, Will Robinson!” – Patients who complain about a previous doctor (“That Dr. Smith, he was no good. And the one before him was even worse”).  You’re next. .. If you hear that from a patient, don’t plan on rescuing them. My experience has been that you will find yourself in a deep hole. This does not mean that a patient can’t have seen multiple doctors without results – we see those patients a lot and they are wonderful. I am talking about the type of patient who is not willing to accept responsibility for their health and wants to blame the doctor for all bad outcomes. Patient history is really important – their treatment history, their communication style, and what they are looking for in a healthcare provider are all important factors in whether or not this person is an ideal patient

Lots of patients you’ll walk into the room for their first visit, and man, they just connect. They’re open. They ask questions. You can provide feedback, and it works. Collaboration – it’s talked about a lot, the idea of shared decision-making. Not every patient really wants to do that.  We hear a lot, “You’re the doctor, what do you think?”. And I can tell them, and then I engage them, and we use technology as well. It’s better than a portal. A portal is good, but an open note system is where every bit of data is available to the patient (all the lab work, every visit, every phone call, and every message). Patients who like that are ideal patients. They want to know what’s going on. We want them to know what’s going on. And what we find, is that the staff has to deal with a whole lot fewer phone calls. I can’t remember the last time we had a late-night phone call from a patient. We have a couple thousand patients, and we don’t get them. We have provided our patients with all that they need to understand their care. All of this is done through our technology system.

The Referral Potential of a Patient

I do consider a patient’s referral potential. Some people think this might be self-serving but we all are in some sort of business and referrals matter.  People have networks of friends. They belong to a community group – whether it’s theater, or art, or music, or church (or whatever). People are super valuable to your practice, and they’re likely to refer like-minded people from their social network. In our practice, I would say at least 50 percent of the time (and I hope a lot more than that), I thank patients for coming in and seeing me. I say, “Thank you for coming to see me today”. And then I say to these ideal patients “If you have any friends who you think would really benefit from what we’re doing, I’d love to see people just like you because you’re awesome”. And I mean it, I’m not making it up. I mean, I love my patients. And when you invite them to send their friends who are just like them, they do. The whole point is to recognize that patient loyalty stems from trust and a real connection. Sometimes it takes more time than a quick, urgent care kind of situation. When patients feel understood and valued, the chances of them returning are dramatically higher. Once I understood what I was looking for in an ideal patient, I stopped marketing to the general public and moved in a completely fresh direction. I could stop experimenting with a magazine, or a flyer, or, all the things that don’t work, and begin attracting patients who aligned with my values and were willing to invest in quality care (A big piece of this alignment is a cash practice, right?).  Patients know that insurance is not going to provide them with the highest quality care. In primary care, cash is king. It’s the only thing that works for both the patient and the practitioner.  The above examples are the rubric for – “How we find an ideal client? Why is it valuable? How it works?” Give a little thought to what your ideal day would look like. What kind of patients would you like to help every day? Focus on that patient demographic and start to build what gives you joy.