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Starting My Own Online Clinic

I Can Start My Own Online Practice For <$5,000

Dr. Wible will teach you how to start your own practice for the least amount of money upfront and an ongoing overhead as low as 7%. At least this is what she claims on her website, she is all about physicians choosing the practice that’s right for them instead of just slaving away seeing patients.

She has what appear to be a wonderful course, either in the form of a retreat or online, which takes you through the entire process of starting your own brick & mortar medical practice. But this post isn’t about me advertising her course.

Most of us have tunnel vision because we are already burdened with our work loads, trying to stay afloat in our daily practice, looking up & around to see what else is out there is incredibly hard to do without losing focus.

In this post I want to talk about my move to starting my own practice, not a brick and mortar office but a virtual one, an online medical practice.

The Cost Of Doing It All Myself

In order to build an online practice I would need to purchase an EMR, I would need to farm out billing, I would need to purchase my website and pay for enough bandwidth to accommodate my patients.

I would also need a communication platform that is HIPAA compliant, reliable and expandable so that I can communicate with patients online. Changing laws regarding virtual care require a company that can make changes to their platform in a timely fashion. It needs to allow me to expand my practice to other States if I choose to do so.

I would need customer service for patients having trouble with billing or the software. With an online practice there are a good number of refunds, connection issues and problems with medication submissions.

I would need marketing. This is something I could do myself but it would be very tedious and I don’t have any good strategies to integrate social media. I likely would need to hire out marketing the first 2-3 years of my practice.

I would most definitely need to hire a lawyer, whether hourly or on a retainer basis, in order to draft contracts, publish the right wording on my website and deal with any changing regulations.

I would need a separate account with LabCorp or Quest Diagnostics to submit my labs and be able to review them online.

I Could Have 1 Company Do All The Work For Me

HealthTap is advertising their Concierge service to doctors for an absurdly low price of $350/month. But let me break down the fees and costs because there is more to it.

 

To sum it up, they offer everything I mentioned above for a monthly fee + per-visit-fee. This includes:

  • dedicated account manager who is a virtual care expert
  • ongoing customer support
  • patient recruiting and marketing
  • integrated billing solutions for cash/insurance payments
  • EMR for documentation
  • Integrated lab ordering
  • Integrated medication ordering

 

For $350/month you get access to their website.
For $1/visit you also get malpractice insurance.
For $10/visit you get everything mentioned above.

So, you would be paying $350/month plus $11/patient-visit in order to have your own complete online practice.

 

Who Is The Ideal Candidate For This

I think this is the kind of practice that takes some time to build up, proportional to your marketing skills. As you can imagine, most large medical groups are not going to want you to have this kind of practice on the side because they don’t want their patients leaving their insurance network.

It’s great for someone who wants the flexibility of doing per diem work, who has patients they love and want to keep forever and those who want to transition to an online-only presence.

It’s also great for someone who has their own practice already but doesn’t have a good way for their patients to have access to them. Most of us are answering patient questions for free right now through email or voicemail. It appears that the market demands the physician to be remunerated for such interactions.

Specialists can use this for an easier way to have follow up with their patients. As a dermatologist, you may have prescribed Aldara and now your patient is freaking out because they have a lot of redness on the affected areas – a quick video chat would allow the patient to be reassured and for you to close the care-gap.

How Do I See Myself Using This

I don’t find it hard to establish and cultivate an online presence, it’s one of the skills I’ve been able to pick up quickly on. It’s very important what kind of presence one has, if all your online reviews are shit or you are on a ton of paid sites then you may have a tougher time establishing your online practice.

I would like to slowly build up such a practice because I come across rare patients who just happen to click with me, they like me and want me as their go-to doctor. They don’t even want to change their insurance or their PCP, they just want easy access to my care.

I see myself wanting to continue doing random per diem work, just enough to pay some bills or have a little walking around money. I will likely pick up such patients during my per diem shifts, those who want me to be their doctor. That’s how a concierge practice is born.

I also love doing underserved medicine. I find it gratifying and I love that particular patient population, I click with them.

I can have my concierge patients who are willing to pay my asking price, and I can charge a much lower price for my less affluent patients.

A Not-For-Profit Practice

I’ve considered even making my practice a non-profit. In such an online practice, I would see patients from all levels of the financial ladder but feed the majority of the income back into the practice, having the rich pay for the poor.

My income would be a small salary, somewhere in the $3k/month range. My overhead would be covered by the income, as would my taxes.

 

My Next Steps

I had an initial phone conversation with a sales rep at HealthTap. Viet was wonderful to speak with, she seemed knowledgeable and had good insight into how other clinicians are already using HealthTap to generate an income.

Next, I will have demo session with her, using a fake patient whom I will manage using HealthTap’s platform. I’m also going to want to delve more into how other doctors are successfully running their virtual practices.

If everything goes smoothly I will sign on the dotted line, start my practice and slowly, over the next few years, build up my patient base.

 

Update: HealthTap turned out to be a dud for me and there were lots of issues which I couldn’t resolve with them. In the end they refunded me my money and I moved on. I have since contracted with Vsee and have been incredibly happy with them.

 

11 replies on “Starting My Own Online Clinic”

Awesome. This is sort of what I’m hoping to achieve. Though perhaps it would take me too long to build up my concierge census. Seems like a financial loss at the beginning – and what do you do with this patients who would like to follow with you (say you meet them on telehealth visit or even urgent care or ER) but you haven’t started your health tap site yet bc you don’t have enough patients ? You can only tell so many people to “hold on for a couple months, then I’ll let you know.” Or maybe you can do that , beats me. And does health tap bill insurance companies ? Or is this literally concierge care , namely, patient pays cash. Even harder to build up that kind of patient base! I just recently created my health tap profile (though haven’t had to my credit card info in anywhere yet … )

I have included update on HealthTap in other posts – it’s a very shady company and I had a terrible time with them. I don’t recommend HealthTap and have since switched successfully to Vsee.com. Billing will be up to you. If you purchase billing through the telemedicine provider then you don’t know what quality you’re going to be getting. It’s better to handle that yourself or farm it out to a reputable medical billing service.
If you have a strong online presence then your patients can sign up with you or follow you even if you don’t have a virtual platform yet. But if you’re planning on building that following then I highly recommend to start it now. Just be sure to not step on your employer’s toes. You can see those patients both in your employment job and in your private practice, whether in-person or virtual. You might even have a non-compete term for some time after you leave.

thanks for the response, and for the update! man, i got nervous and had to check my accounts to make sure they didn’t charge me without my knowing. ok, good to know – basically, avoid healthtap. will look forward to your posts in the next few months on your vsee life.

It’s a good idea to find a specialized field in telemedicine as opposed to doing something general like an online urgent care. The competition for that space is insane. If you can focus in on patients with a particular disorder then you can probably charge a much higher consultation rate and spend less on CAC.

This was a very helpful article. Thank you for taking the time to write this article.

Glad it was helpful. I wish that it worked out well with HealthTap – the potential was there. I have a lot of hopes for Vsee. So far it’s a much better platform and their support is incredible. I need to invest more time marketing my services with them but there is no rush.

I am a PA wanting to start a virtual concierge medicine service with a focus on functional medicine. I have a good friend who is wanting to join forces and be my supervising physician. I just need to know where to go to ask all of the legal questions regarding telemedicine practice. Where did you go to do that research? Did you hire a lawyer?

thanks in advance!

Sara

A lawyer is best for questions which you cannot answer yourself. The cheapest approach is to learn everything by talking to a telemedicine company such as VSee and then confirmed everything with a lawyer 1-on-1.
Having a good practice attorney is also nice because you can ask them any questions which might come up from time to time. Many telemedicine software providers will have a ton of resources, so maybe start there.

I had another person who contacted me on here and was planning the same. It’s not that hard to do. The most amount of time you’ll spend is recruiting customers which can be rather pleasant since it’ll help you filter the right people for your platform and you can learn even more about Homeopathy in the process. Best of luck.

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