Where do you see yourself seeing niche patients? Is this work going to grow out of our exisitng clinic? Is this work going to be at a larger dedicated facility – emergency, cardiac testing? Are you going to start your own bricks an mortar practice? Are you going to start a mobile service – visiting nursing homes, new mothers? Are you going to have a fully virtual service like coaching, mental health, health advocacy?
Sometimes the answer is obvious – an interest in correctional medicine is going to be at a jail. An interest in emergency medicine is going to be at hospital of some type (although technology is changing this – look at the Virtual ED work the Northern Hospital in Melbourne is doing). Getting involved in cardiac stress testing, tiltable testing or sleep studies is going to be at a facilty with these types of infrastructure. A surgical niche is going to need an accredited clean and safe location, maybe with the ability to process and sterilise instruments. After this however, things can get more flexible and ripe for innovation. One of the great things to come out of the covid pandemic was the more rapid adoption and confidence with telehealth. Many niche practitioners are now working purely on a remote basis for their niche, from home, practice or from a co-working space.
There are real benefits to starting in your existing practice
Working in your existing practice speaks to the the MVP idea – the walls, heating, power, software, booking and billing software is all there and working so you can focus on the niche and bringing in your ideal patient. There is already a safety net here as well – even though you may not feel delighted with seeing all comers with coughs and colds, paperwork and GANFYD requests, it is a reliable income that can sit there propping up your cash flow while your niche builds. There are also doctors in the practice who are easy to reach to educate about your developing niche and send patients to you. Reception can direct these patients to you. These patients are also warm contacts – they hopefully know, like and trust the practice and so will be happier to come to you as the new skin cancer doctor rather than be interested in seeing someone unknown at the Mole Photography clinic down the road.
Your own clinic will have a lot of processes and databases already – address books, results management, recall systems, billing systems.
Depending on how pro-active your clinic ownership team is, there could be funding to support a new website, equipment or marketing. Caution there that they may feel they own any marketing or website assets created which would be difficult if you wanted to set up on your own and move on.
The exisiting practice will have a physical location and therefore is perfect for Google My Business listings which is important for obtaining reviews. Although not impossible, this is harder with virtual clinics.
Problems with developing a niche in the existing practice?
There are downsides to developing a niche in your own clinic. Chief here can be differentiation and blurring of roles. You start offering your niche in MHT, but consultations blur with the pt also asking for this carer form to be completed. You set your prices to reflect the extra work you have done to develop in a niche but your regular patient does not see the value in paying you for this time and tries to shoehorn every thing into a regular appointment. You are trying to develop patient aids, website to support your niche but keep getting interrupts for Mr K’s webster pack prescriptions.
You can get around this, often by compartmentalising the work – for examples skin checks are only on Saturdays. This may require a new clinic to be set up in your booking system to only allow this one type of consultation at this time. You may want to have discrete pricing and time for your niche – “new peri-menopause appointments are 40minutes and cost $266”
One thing the booking systems don’t seem to be able to offer so far is quaratining your calendar screen for different sorts of appointments. So on a given Tuesday morning, cough and cold patients can book all the slots and your ideal patients may not be able to book in.
There could be marketing differentiation problems as well. Local SEO is greatly aided by Google My Business profiles. If the original clinic owns the GMB profile for that address, are they going to be happy with you establishing a GMB profile at the same site (it can be done, just needs buy in by the original practice).
Reviews on Google are essential. Will the main practice allow or set up a GMB for your niche area so that reviews can accumulate there, separate to the main clinic. If doing this you need a way to prompt/ask patients for reviews that only relate to your niche set up, not the main clinic. Some of the automated review requesting systems like HotDoc will send a SMS after the apptointment, asking the patient for a review – this will link to the main clinic google listing. So if you desire reviews for you niche service at the same location, you will need a QR code or link that takes the patient to your niche review GMB, not the main clinic. You may need to ask the main clinic to turn off their automated review asking service.
If there are expenses – marketing materials like website, Facebook or Google advertising, equipment who is paying? Who is claiming the business cost in tax? Who owns the intellectual property you have developed in patient information, workflows, videos? This is important long term if you move, the main practice sells or you want to sell your niche.