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Physical vs Virtual Practice in Medicine

It’s 2020 and for most businesses it doesn’t matter if you offer your product or services in a brick & mortar medical office or an online office. Customers, these days, have the same access to a website as a curbside business.

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.

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.

Competition are 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.

Noise comes from all the other websites and business online, most of which don’t make any money. They are online and they might come up in a search, but they can’t/don’t take their work seriously, making it easier for you to stand out.

Barriers to Entry

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

The photo industry was transformed by the digital camera. The telecommunication industry was transformed by the cellular phone. The transportation industry is currently transforming because of ride sharing.

The Physical Medical Practice

The physical medical practice might offer services which 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, via a virtual medical practice.

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 which require physical presence. But, as you’ll see, this doesn’t always hold true.

The Virtual Medical Practice

I have a virtual practice and I sell digital products to other medical professionals. Most don’t even know my full name, where I’m living, or what I look like.

The eye traffic in a virtual store beats the digital pants off of the foot traffic at a physical store. But, can you convert the stares into sales? Of course, we’ve discussed that in previous posts before.

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.

I am now working on building my Virtual Medical Store. There, I will sell digital products directly to patients. The risk will be lower and I’ll reach more customers.

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 store.

The virtual store doesn’t always have to sell a product, like a book; they might 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, all can 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

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.


Mental Health.






If you have a great idea and if you are passionate about the work, don’t just 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.

PA’s, NP’s, 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 vs 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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