A Good Trend

Middle of June tends to be a slow time. Weather is getting warmer. Lots of graduations and proms. No one has time for their health. So its a good time to catch up on other work.
But no one told my patients about the middle of June.

Today I saw 14 patients.
1 new patient joined a wellness plan.
1 other joined himself and his wife into my wellness plan.

I have decided that patient's like to know they have a ceiling on their medical bills, at least in my office ;)

But I have had a good trend over the past 30 days that I hope bodes well for the future.

Over the past 30 days, of which I worked 17 days, I had 27 patients sign up for a wellness plan.
Stil nowhere near the 1000 I hope to eventually have, but:

Of the 27,

10 were renewals

3 were new members, but prior to were existing patients

and

14 were totally new to my practice

Of the totally new patients,
3 were referred by a local pharmacist,
3 from an acupuncturist
4 were referred by other patients
2 by my wife
and 2 from advertisements.

Most admitted to checking out my website before scheduling and joining.

So hopefully, marketing and word of mouth are starting to take hold. My practice can only grow by maintaining my existing patients, but as important, bringing in new!

Wellness Growth

I run a small solo and independent family practice office.

I took the initaive in 2008 to decontaminate my practice from the pests that make up third party insurers. I knew that initially I would take a hit, but that word of mouth would again grow my practice. I do not like to be out of control. That includes the growth of my patient base. As many who have been following this blog know, my practice consists of the following:

1. Wellness Plans- prepaid or yearly contracts with monthly auto-debits
2. Traditional Medicare
3. Self-pay with payment at time of service

As mentioned in previous posts, my expenses have gone down, my available time to spend with patient's has gone up, and being a doctor is once again enjoyable. But unmanaged growth can change that. My goal is not to build a huge practice with large staff and overhead expenses. Thus managed growth is the key and it appears to be happening without any further change in my practice style.

My goal is to have between 600-1000 active patient's in my practice. I would like to have 60-75% in my prepaid wellness plans. These plans allow my overhead expenses to remain low.

Comparing June 2008 to June 2009:

There is an increase of 19% in Wellness plan patient's.

20% of 2009 wellness patient's are totally new to my practice.

7% of 2009 wellness patient's switched from self-pay to this plan.

When I opened my practice in 1998, it took a few years for the word of mouth to make me busy. That appears to be happening now, but I am not looking to be "busy" with bureaucratic and government insurance regulations, but instead busy on direct patient care.

So far, I am on goal. I only hope that "Government healthcare reform" does not push me off course. That would be a bad thing for our profession and even worse for our patient's.

DoctorSH

May 2009 stats

May 2009 has been an interesting month.



I will present some stats that I find interesting.



Patients seen for the month of May 167.

New patients to practice 10%

Wellness patients 39%

Selfpay patients 42%

Medicare patients 19%

Average $/patient for May $123.61

Average $/patient for 2009 $100.69



Numbers are only as good as the interpretation. To understand their meaning you must understand my practice. I participate with no insurers other than traditional Medicare. I offer fee for service and wellness plans with either a full prepay or auto-monthly debit option. Advantages to full pay are obvious. Total payment upfront helps the monthly numbers, but each further visit during the year brings in no further revenue. The auto-pay monthly debit does little for the monthly numbers, but works similar to capitation, WITHOUT the insurance middleman. For adults 24 and over the autodebit is $45/month, much higher than traditional HMO capitation.



What I find interesting is watching the % of revenues that comes in each month from the auto-debit option. As the contracts last for a minimum of one year, this will continue to grow each month. In january the percentage revenues was 2%, and now in May is up to 9%. At this pace I may be up to about 20% by years end.



As always, it is important to continue to sign up new wellness patients. At present revenues from full prepay wellness patients averages 35%. So a bad month in new sign-ups would not be a good sign.

Interesting Discussion with a patient

I had an interesting discussion with a patient yesterday. She works as a schoolteacher at an elementary school one mile from my office. She and her family have been with my practice for about 8 years and have referred many new patients to my office. Surprisingly, over the past 2-3 months, I have seen and heard very little from her. She came in yesterday to discuss some health issues and to "feel me out" on whether my new wellness plans were right for her and her family.

Her daughter is about to graduate from high school and has gotten accepted to a very prestigious college. Unfortunately, prestigious colleges come with a high price tag. She told me she had to watch her pennies a bit more, and was upset at my new pricing structure. In fact, she and her daughter had a few visits at another local doc who accepted insurance. Yet she came back in for a visit and to talk.

The question is not why she tried another doctor. That is purely a financial motive. The question is why did she come back?

1) Trust
2) Value
3) Excellent Doctor-Patient Relationship
4) Long history with family

She not only came back, but re-enrolled in the wellness plan, with the auto-monthly bank debit option. She threatened that I would "lose money" on her as she would come in more frequently. I laughed and smiled, and said "Bring it on, That does not scare me. That is my job!!"

Pearl of the day:

Trust and Value are extremely important in any doctor-patient relationship. With a cash practice, with no third party intruders, it is easier to build and maintain!!

DoctorSH

It's been a few weeks

It's been a few weeks since my last post. Daily posting can get cumbersome after a while, but I am back!! I have realized that looking at daily numbers does not give a good overview of my practice transition. It is similar to a dieter checking the scale before and after each meal. Just too much information. So I will continue posting, but at a slightly decreased frequency.

Since April 20th, I have worked 10 days and the following occured:

patients seen 102
New patients 4
Wellness Patients 42
Selfpay 39
Medicare 17

26 Wellness Plan enrollments
21 were renewals
5 previously selfpay patients enrolled.
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The wellness plan enrollments alone almost pay my overhead. So the goal, as always, is to increase this part of the practice. I am presently researching additions to my plans that would encompass more dietary, holistic, cardiac and corporate versions. As the 2008 to 2009 wellness plan renewal rates are over 80%, with some patients just delaying coming in to renew, the concept is working. Now the object is to get to 1000 active patients and close the panel and become a doctor first and only, instead of a doctor , businessman, and marketer. The best run medical practice is one that grows from word of mouth with very little marketing. But it takes a few years to get to the level where this will occur. Until that time, I will continue to actively market my practice, my ideas, and my views on patient care. I will try to attract the type of patient that wants my style.

I have another blog that I write for my patients. The patient response has been terrific. In fact, half of my patient visits end with the statement, "Doc, keep sending me those email newsletters you write." It has been the most productive practice builder and goodwill generator of my career.

It can be found at http://drhorvitz.blogspot.com/

DoctorSH