Saturday, February 4, 2017

Seesaw of Survival: The Missing Ingredient to a Thirving Free-Market Medical Practice




“Progress is impossible without change, and those who
cannot change their minds, cannot change anything.”  ­
- George Bernard Shaw


The doctor who invited me to lunch was looking down at the white table cloth, running his fingers around the borders of the still empty plate, as he humbly confided that he was ‘lost’. After 16 years in an integrative practice, having invested a small fortune into a centrally located office, and the latest technology with an equally impressive price tag, this remarkable healer was at wits-end to the unrelenting up and down’s of his outwardly successful practice.

There is a place between success and failure that I’ve come to know as the seesaw of survival.  It seems most prevalent in the business of healthcare especially. Brilliant, gifted and passionate healers who spend their entire career working very hard serving their patients, spending long hours in the office, and lost in thought at the dinner table, who never experience the geometric growth that can be seen everywhere else in nature.

At the point of conception, a new life begins with just one cell, then it divides into two, four, six … twelve, thirty four. A trillion. If it followed the linear progression of most health businesses it would never survive. Fortunately, or paradoxically, a practitioner can subsist by the hairs of his chinny chin chin for decades, never failing completely but never succeeding entirely.

Over the years I’ve had the unique opportunity of interviewing and hosting remarkable healers who seemed to have accomplished the impossible, they’ve developed a seven-figure practice that depended very little, or not at all, on the angry bureaucracy of third-party reimbursement. They fell back in love with the practice of medicine, their patients experience the healthy benefits of a time-generous practice; and the doctor has the personal time to actually enjoy life. Having spent the last fifteen years in the business of marketing integrative doctors (before they were known as such) I’ve personally known physicians who were able to propel to astronomic personal and financial success, as well as those who continued to, for the most part, keep their head above water, lamenting their lack of business and marketing acumen for the frustrating state of affairs.

The latest, most advanced vehicle, when driven on fumes will never tap its innate ability for full self-expression. It will never be able to perform the way it was designed or reach the speeds it is capable unless it has the fuel necessary to perform at its maximum potential. The fuel of any business, including healthcare, is its ability to reach and educate the public about the unique attributes of its service. Build trust; impart knowledge, confidence and understanding, while conveying a palpable proficiency to help solve my problem.

In a recent interview with Doctor Ronald Hoffman, MD the founder and host of the “Intelligent Medicine” radio program, and Manhattan-based center bearing the same name, the well-known practitioner and pioneer of the modern integrative medicine movement, shared the humble beginnings of his impressive success trajectory. Once he graduated medical school it did not take long for him to realize the limitations of an insurance-based practice. So he left that model, and hung up a shingle for his free-market, direct pay center. And although consumed by fear and doubt at first he knew that this was the only way he could practice the kind of medicine that made sense to him.

In the early days Dr. Hoffman would search out any opportunity to speak to groups, even though he thought of himself as naturally shy, and a public speaker who he considered to be awkward at best. Willing to drive to a different borough and subject himself to the life-draining traffic of our bustling metropolis, he would address intimate groups that could comfortably fit around a kitchen table, at some tiny health-food store, and share his unusual perspective on health and healing. As he developed a proficiency of speaking in public, an opportunity presented to host a radio program, on a small scale at first, but then nationally, reaching millions of people who he was able to educate, serve, and provide a valuable perspective without seeking anything in return. This generosity and consistency endeared a generation of listeners who saw Dr. Hoffman as the expert of experts and lined up at the reception desk of his modern office.

To activate your Flux Capacitor, according to the eccentric Dr. Emmet Brown of ‘Back to the Future’ fame, you have to reach 88 mph. If your DeLorean Time-Machine only reaches 87 mph, you will cruise at that speed forever or until you crash into the movie theater at the end of the mall’s parking lot. To get your health business to propel beyond the seesaw of survival, you must engage the local market and you must do so consistently, boldly, creatively and unapologetically. Most practitioners, who spend money on marketing, do it as an afterthought, cautiously reaching 15 mph; surprised and frustrated by the sparse results. In fact they only remember to do any promotion at all, when the eerie quiet emptiness of their office and a very bored front desk person reminds them. That is the main reason why potentially great practices never make it out of the mall’s parking lot, and great healers remain a local ‘best kept secret’ carefully passed down from one ecstatic patient to the next like some valuable family heirloom reserved for the benefit of a select few.

It is also why the insurance and drug companies took control of healthcare, for they have no qualms about spending a significant portion of their resources on getting in front of the public, and telling their story.

As a nation, we are one of the most unwell generations of people who have ever wobbled to a local artery clogging non-food establishment, exhausted from lack of physical activity. There is no dearth of people needing your expertise there is not one person who wouldn’t benefit from your advice or care. Our entire three trillion dollar medical system is focused on the indefinite management of disease and the clumsy suppression of symptoms resulting from a chronic and unaddressed underlying cause. There is a problem with the infrastructure of this model of care, and the modern, proactive doctor, who wants to focus on helping her patients thrive at their maximum level of human expression, is sacrificed on the altar of a third-party controlled system of medicine and the bureaucratic payment schemes that promise the illusive access to free care.

Your only competition is not the doctor across the street but apathy among your neighbors. Other practitioners can be a source of referrals, comradery and support, but if the public is not educated about the merits of prevention, if they are not motivated to take action on improving their wellbeing, we will continue to experience the devastating results of escalating diseases of neglect.

When you signed a contract for your office space, you agreed to a monthly expense that came along with it. It’s part of doing business. You pay your rent when you’re busy and you pay it when you’re slow. It’s a commitment that is included in your annual budget. And one that is built into your fees. I believe that if you are to break the inertia and get off the seesaw of survival, your marketing investment should be at least 10% of your gross revenue, and be included in your expense projections for the year. It is the fuel of your business and one that is missing in most free-market healing centers that I’ve seen. If you don’t engage a properly fueled engine to take you where you want to go, then you have to rely on the wind, the current, and the kindness of strangers.

Marketing, why none of it works, and how all of it does.

With the new political environment there has never been a better time for the entrepreneurial-minded doctor interested in a free-market practice to thrive. The soon to be de-regulated three-trillion dollar system of care will become more malleable and ready to be re-engineered into one that is wellness-oriented, prevention-minded, accessible and affordable for those who need it.

If things are to get better, as it regards our national well-being, someone has to make the time to take a stand.


Health Media Round Table
Free-Market Think Tank


  • ·         At this live event, like-minded practitioners have an opportunity to introduce themselves and their healing approach to local colleagues, who can be a source of ongoing referrals.
  • ·         We discuss innovative ways to engage the market and develop a loyal following.
  • ·         Real-time feedback on what kind of marketing compilation garners the best practical results.
  • ·         How companies with proprietary professional products and innovative technology can help our doctors access a marketing platform and leverage their promotional resources.
  • ·         Effective free-market practice structures that allow for a life-long relationship between doctor and patient, gutting perverse incentives, and creating the time necessary to address the underlying cause by laying the infrastructure for prevention and optimal wellbeing.
  • ·         Learn from successful healer-entrepreneurs who share the steps they took to achieve impressive tangible and intangible rewards available solely in a free-market practice.
  • ·         How breakthrough technology will improve the relationship between doctor and patient and refocus care from the management of disease to that of human optimization.
  • ·         Discover the latest products and companies that will enhance your practice and impact the efficacy of patient care and retention.
  • ·         Understanding the role of money is a tool and how instead of working hard for money you can get your money to work hard for you.

For an invitation to a future Health Media Round Table please send your contact information to alex@healthmedia.us or 516.596.8974.