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Physical or Virtual Practice in Medicine

It’s 2023, and for most businesses, it doesn’t matter if you offer your product or services in a brick-and-mortar medical office or an online office. Customers, these days, have the same access to a website as a curbside business. Which is why a physical or virtual medical practice is something worth considering.

In a physical vs virtual practice, the only difference is the location – the service is the same, the clinical outcomes should be the same, and the value you offer your patients should remain unchanged.

Competing Online

Especially if your widget is a service, it’s much easier to succeed in the online space – and save your customers money. The main barriers to go online are competition and noise.

Your competition is the other virtual medical services with whom you have to compete. Many have hefty advertising budgets. They can spend a ton but have very little flexibility. But they are also impersonal and can’t compete on quality or customer service.

Noise comes from all the other websites and businesses online, most of which don’t make any money. They are online, and they might come up in a search, but they haven’t had much traction, making it easy for you to steal the show.

Barriers to Entry

But there is one other barrier for medical professionals when considering a physical vs virtual practice, and that’s the bias of the current norm. We assume that because most medical offices are in physical locations, the only way to succeed is to imitate them.

Though many patients might still believe that their in-person practice beats the pants off the virtual practices, you can change that paradigm. The kind of attention and customer service you can offer virtually is hard to match by any physical practice.

The Physical Medical Practice

The physical medical practice might offer services that must be delivered in-person:

  • physical therapy
  • behavioral health
  • gynecologic procedure
  • IV treatment
  • medical spas

Or, do they? For each of these medical business models, clinicians have figured out or will figure out ways to provide similar services online. For better or worse, mobile IV and X-ray units are abound.

The advantage of the physical medical practice is that you’ll attract more traditional customers. These individuals feel comfortable with the brick & mortar model. They trust it and believe in it.

Also, you can likely make more money from fewer customers because you’ll be offering interventions that require physical presence. But, as you’ll see, this doesn’t always hold true.

The Virtual Medical Practice

The virtual medical practice doesn’t require a renovation or furnishings. It can be constantly upgraded and remodeled to retain more customers and offer new services.

Your waiting room and signage is your website. Your exam room is the telemedicine software you use. And your after-visit summary is the patient portal where your patient can interact with you live or asynchronously.

The risk will be lower, and I’ll reach more customers. In fact, my own virtual practice, DNH, is the kind of low-risk virtual practice I’ve always wanted to run.

The Virtual Medical Professional

I’m excited to see more non-physicians going online. Many of you have contacted me and told me your story. Others, I follow online and see them grow their virtual presence.

They are essentially running a virtual store which doesn’t always have to sell a product, like an ebook or online course; they offer 1:1 patient care, consulting, training, coaching, or education.

The virtual medical professional can be a digital nomad, working from a laptop, from anywhere in the world. They take advantage of locations with lower cost of living and better quality of life.

Physical therapy, mental health, infertility care, weight loss, and even urgent care medicine, can all be delivered online. And all are being delivered online.

While some are sitting around wishing that they could be earning their money online, others are going for it. They are providing career satisfaction for themselves and they are offering an important service to their clients.

Physical Practice Costs

  • lease contract
  • time to find the space
  • space renovation
  • furnishing
  • utilities
  • insurance on the physical place
  • property/city taxes

Virtual Practice Costs

  • website hosting
  • software leases
  • app subscriptions
  • malpractice insurance

Virtual Medical Practice Ideas for Medical Professionals

Infertility. Help 10,000 women a year to improve their fertility through lifestyle interventions. Take them through a 12-month online coaching course. At $150 per-member-per-month (pmpm that’s more than $1M of income.

Autism. Help 5,000 parents improve the lives of their kids with autism. A subscription website where you curate all real-life data for such parents at $100/pmpm is a $500k/year income.

Polypharmacy. How can patient’s cut down on the number of medications they take? How can they cut costs on their current meds? Can they replace some traditional meds with herbal remedies? Tons of advertising opportunities with such a website.

Prevention. From CEO’s to head of rich of families, many are looking to extend their lives and prevent chronic diseases like cancer and Alzheimer’s.

  • Biofeedback.
  • Mental Health.
  • Dementia.
  • Caregivers.
  • Athletes.
  • Diabetes.
  • Rehabilitation.

If you have a great idea and if you are passionate about the work, don’t just sit on it; take the first few steps to see if it’s viable. The old idea of having to have a physical medical practice is rapidly aging. Welcome to the new millennium.

PAs, NPs, Pharmacists

Physicians like myself get blinded by the high salaries we are offered at traditional medical groups. Many of us are pacified by the promise of a lifelong career in such medical settings.

Yet, it seems most such clinicians are or will burnt out. By the time they want to hop the fence, it’ll be too late.

If you’re a PA or NP or Pharmacist – or if you’re in any other non-traditional medical professional role, you have the first mover advantage. You can leave your colleagues in the dust.

It’s better you earn $120,000 doing something you love than $170,000, where you feel every day is a grind.

9 replies on “Physical or Virtual Practice in Medicine”

Dr Mo,

For telemedicine, how many individual state licenses is it reasonable or expected for one to hold?

As full time Urgent Care doc at the end of my rope, thank you for providing hope.

Some have only 1 and that’s more than enough, such as in CA or TX. Others will have 15-20. It depends on how many platforms you’re on and how many patients you want to see. I just addressed this on a recent telemedicine podcast episode, it’s worth listening to.

Dr Mo,
I’m a psychiatrist and currently do a combination of office and telepsychiatry work. I understand that I must be licensed in the state where the patient is located. But if I decide to reside in a different country, say Spain, do I need to be licensed in that country in order to continue seeing my patients online who are in the US?

Great question, no you don’t. You can practice online telemedicine from Spain but you’re not allowed to see Spanish patients. For now there are no laws against it and I don’t see anyone pushing for such laws which is something I follow closely. But I do see the US trying to limit doctors from living in other countries and working there and seeing patients there. I see the state medical boards trying to create rules regarding this. But that’s only if you’re employed, if you have your own telemed practice, nobody can force you to be in a particular location to see patients.

This is a good rundown of the differences between physical and virtual practice. The “best” choice seems to come down to preference, as everyone receives medical attention and care differently. It’s good to see that patients aren’t short on options.

Can anesthesiologists practice telemedicine ?
If not then what is the locum rate for them per hour?

Not anesthesia, no. But they could offer virtual services for whatever they are an expert in. It also depends on what your training was to get to anesthesia. You can talk to patients about the kind of anesthesia they could use and to recover from side effects of anesthesia – there certainly would be opportunities there.

Where is your PLLC based? and how do you cut the costs of taxes and cost for tax preparations when you live overseas?

I don’t have a PLCC – sole proprietorship.
My tax rates are low enough that they aren’t worth factoring in.
My income is around $100k per year and with a large write off I pay around 10% in taxes.

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