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Cash Pay Telemedicine Practice

This is my fourth attempt at building my cash pay telemedicine practice. Not that the other attempts were failures, but they weren’t the right fit.

Telemedicine platforms, SaaS, and EMRs, have all improved, making this next attempt a better one.

My Current Private Practice

My current cash pay telemedicine practice is a word-of-mouth practice. I get patients referred to from other providers and friends of friends.

A niche practice is what I wanted in the past. Now I want to focus on something more general. A mix of primary care and urgent care seems to be the right fit for me.

Past Attempts

I built out and marketed my niche telemedicine practice for rock climbers. But I realized I didn’t know enough or certainly wasn’t comfortable taking care of this already-healthy cohort.

I built out a traditional urgent care practice using the Vsee platform, which was clunky and glitchy. My patients eventually made it through it, but it was pulling teeth.

Next, I built my practice somewhere else, on someone else’s platform. But Healthtap seemed shady or at least lacked the transparency for me to want to continue there.

Disappointed with Current Work

I make plenty of money seeing telemedicine patients for other companies. It’s not the income but the experience that’s lacking.

On one telemedicine platform, there are so many restrictions I don’t even know how to manage simple back pain. I can order X but not Y and must send all patients with Z to the urgent care.

On another platform, patients are swindled into monthly subscriptions. They sign up for a single physician visit and are upsold on a monthly subscription that they can’t cancel or they never requested.

Cash Pay Telemedicine Business Model

I’m a fan of free primary care. Not the primary care we see in western medicine which is mostly pushing medications. Instead, primary care that empowers and educates patients and builds relationships.

The primary care part of my cash based telemedicine will be free. Which is essentially a marketing tool for me to find patients who’ll then pay me for their acute care needs – for urgent care visits.

1. Clinica Services

I will start with urgent care and slowly add in primary care. I will charge for the primary care at first to cover overhead.

Acute care complaints include:

  • back pain
  • acute injury
  • eye pain
  • headache
  • eye infection
  • cough
  • sore throat
  • rashes
  • medication refills

Primary care management would include:

  • hypertension
  • thyroid disorder
  • diabetes
  • hyperlipidemia
  • chronic pain
  • acne
  • obesity
  • CHF
  • family planning

2. Audience

It will be easier to stick to a particular patient population. I am aiming at digital nomads. My brand is already well established, and I am familiar with the keywords.

My audience will be mid-twenties to mid-forties tech workers. This group is just starting to look for cash pay telemedicine practices.

3. Platform

Over the next few years, I want to experiment with different EMRs. I have a lot of experience with Athena but have been using Better for some time.

Frankly, the EMRs make the workflow easier but won’t have a lot of impacts since I am not planning on a high-volume practice.

4. Marketing

I will advertise on my own websites, podcast, and Youtube channel.

But I will also use Reddit, Google, and Youtube ads to find patients.

5. Income

In the first year, I am willing to put in 30 hours a week for a $5,000 per month gross income. That’s $1,250 per week at a rate of $40 per hour. Not hard to achieve.

Legal Aspects

I get my legal documents from Medical Justice where I have a membership. This is a great resource for physicians like myself.

I will obviously only work with patients who are residents of California since that’s my only state license. But once I build a rapport with these patients, I can continue providing them care in other states and countries.

State and federal telemedicine rules change constantly. This telemedicine resource guide is a great way for staying on top of the changes.

4 replies on “Cash Pay Telemedicine Practice”

This was helpful. I am graduating with my PMHNP next April. Looking to start on ổn practice after my residency.

Hi doc, how long have you doing this and do you mind disclosing your current patient panel number, overhead cost as well your gross income(ballpark?)

Since about 2018. Please head over to where I host my course. There, we get into the weeds about my own practice. My patient panel and income won’t be of much to use to you however because you and I will have very different businesses. You won’t see the kind of patients I see and you won’t work the hours I work, etc. If the concern is income potential – there are functional med doctors charging $1,500 per consult and there are virtual docs charging just $35 per visit.

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