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Niche Medical Practice

Focusing on a niche Medical Practice to increase revenue and decrease competition

Anytime we think about competing in the same marketplace as our colleagues, we will need to contend with the same dilemmas and overheads. Think of marketing, hiring staff, malpractice insurance, office rent, building out the office and …

What differentiates our family medicine practice or urgent care or dermatology clinic from that of our competitors? For the most part, not much.

The more competition there is, the more money we would have to spend to get a cut of the customers and the less money we will make per customer.

Looking at the marijuana clinic which I am working for, they are charging quite a bit of money per patient. They can do so because they have almost no competition. They have a fairly endless supply of patients and don’t need to do any marketing beyond telling local dispensaries that they exist.

A search engine query of medical marijuana clinics would show a total of 3 Portland locations. One of them is absolutely disgusting to walk into and the other is closed.

Competing With Other Doctors

Let’s say I decided to open an urgent care in my area. I would have to:

  • secure a space
  • sign a lease
  • hire staff
  • buy office equipment
  • purchase a digital x-ray
  • have an inspection done
  • insure my license
  • insure my practice
  • insure my employees
  • train my staff
  • handle ordering supplies
  • find the right medical record software
  • pay for a medical biller.

That covers starting the business. Next, getting the patients to come. It would involve marketing both directly to the patients as well as to insurance companies.

Marketing not only involves the advertising but also dealing with patient complaints and building up the particular services needed in my specific patient demographic. A few 3-star reviews on Yelp certainly would ruin the income stream.


A niche medical practice

In a niche practice, there is far less competition. The fact that it is niche makes it something that’s more sought out by patients and less of something you need to advertise.

For the most part, a niche practice should have a lot less overhead, earn a higher revenue per patient and require less of your time.

If you are a dermatologist and you paint yourself as an expert on nail disease then you will have a lot less competition compared to being a general dermatologist. You don’t even need to be a dermatologist to treat nail disease. You could be an internist, a family doc or an orthopedist.

The ailment

There always has to be a medical issue as the underlying problem. A cosmetic issue, a pain problem, a psych matter, an annoyance, a hindrance to doing something else.

It could be a medical problem that needs management in order for the person to start/continue a job. A problem that is putting the patient’s life at risk or something that’s preventing them from living in the society to their standards.

The intervention

Your intervention needs to be focused enough that it can either only be done by a few doctors or isn’t all that well-done by most doctors. It could be something that’s incredibly time-intensive, something that’s complicated or something that you have developed yourself.

Specialized equipment, and having the expertise to use it, is always a plus.

A surgical technique that has frequent poor outcomes, and which you happen to be good at, would be another commodity which is easily sold.

Your intervention doesn’t even have to be all that different from what your competition provides. It could simply be the way you implement it.

The concierge model is a great example, having taken off incredibly well in certain markets. The same primary care/urgent care is delivered in a higher end practice with longer appointment times and less paperwork and lower wait times.

very successful laser hair removal place I’m familiar with, doesn’t charge per area/per session but charges per minute. You show up and the RN goes to town on you, anywhere and any hair! Brilliant, successful and unprecedented.


For niche practices to succeed I think it’s best to have a clear outcome. Treating something holistically will work but it’s vague. It goes back to the intervention, there should be a clear step that only you as a doctor can take for the patient which produces a certain result.

Using that metric tool as your success gradient (physical appearance, lab value, measured functionality, a prescription, return-to-work status) will make it much easier to attract patients and have good outcomes.

More Free Time

I think the biggest point here for me is that a niche practice would allow the clinician to work less and make more per hour of work. This would ideally be used to generate a great income, doing something one enjoys, while having more time freedom.

When you focus on only one particular management, you can train your staff to do all the peripheral tasks related to the ailment. This frees a lot of your time to focus on what you’re best at.

Doing Something You Enjoy

I can’t imagine doing the same thing over and over unless it’s something I really enjoy. If I sample a full day’s of patients in the urgent care, the interactions which are the most enjoyable are the times when I am counseling someone on how to improve their health.

You might be drawn to a certain patient population. Young athletes, depressed professionals, young mothers, infants etc.


Supercharging your expertise

It’s the nature of a free economy to consider someone an expert when they are one of the few who perform a particular service or when they are the loudest in their cohort.

Naturally, a lot of these niche specialists greedily label themselves as “world renowned” or “the best of…” etc. In my opinion, this isn’t the most efficient way to set yourself apart.

Defy the norm

Don’t be that doctor who needs to blow air up their own ass to appear to be an expert. Instead, pump up your competition. Mention your colleagues on your website or in your conversations.

If you have a blog (which you should) then mention your competition. Mention what they are doing that’s unique and interesting. Mention their websites and services.

This unique ‘selling’ technique has been proven to be far more successful in this information age than trying to constantly put down your competition or do the reverse with yourself.

Share information for free

Talk about everything you do. Don’t worry if your competition copies you, don’t worry if the patient will think that you are charging way too much for such a simple intervention.

Collaborate with clinicians who don’t do what you do in their practice. For example, if you specialize in nail disease, offer to go to local dermatology offices and share some pearls with their clinicians.

You will seem generous, brilliant and chances are, most dermatologist would rather focus on more revenue-generating procedures than dealing with resilient nail disease. There is your referral basis.

Publications make you an authority

For the next couple of generations, our society will assume that anyone who has a publication out there, is an expert. This likely has to do with few having had the ability to get publish even just 10 years ago.

Now, you can publish your own blog, book, research article, podcast, YouTube channel and many other digital and non-digital forms of information dissemination.

Maybe sad to say, maybe not, but if I search nail disease and Dr. Mo comes up on 12 different resources, it’s hard to dismiss that. Especially when Dr. Mo is constantly sharing legit knowledge about that particular disease.

Publish a book

I know books seem like they’re played out now that anyone can self-publish, but there is something very sincere that goes along with publishing a book.

First, it’s a ton of fucking work. Second, it requires a lot of research. Third, it’s a bit of yourself that floats around out there.

I can’t imagine a doctor writing a book that’s just haphazardly thrown together. Most of the time, it will be something well-researched. It might be a culmination of years of experience or a very thorough sampling of expert colleagues.


Sample Niche Practices

disability expert
drug testing
nail disease
carpal tunnel
female hair thinning
climbing related injuries
tattoo removal of facial tattoos
pilonidal cyst disease
ingrown toenails
diabetic neuropathy
migraine/headache specialist
diabetes prevention
plantar fasciitis
medication management/optimization
anal dysplasia
STD clinic
IUD clinic


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