Is the era of the solo practice coming to an end?

There are fear that the solo practitioner will be a rare, or thing of the past. True as that my seem; especially to those whose income and business model is married to third-party payers, there is also a growing part of healthcare clinicians may be ignoring. It is the cash-paying patient. OK, before you dismiss me, hear me out! Most insured Americans have high deductibles, making them cash patients up to 6 or 12k (whatever their deductible is). In addition, a growing part of the population is without insurance. Combined, these two groups make up 51% of Americans. So, why are we bothering to fight with insurance companies when most patients cannot use it even when they have it? Because we have always looked to insurance companies to tell us what we are worth.

Here is the problem with processing insurance for patients with high deductibles. The overhead goes up by multiples whenever insurance companies have to put their blessing on your claim. Insurance is essential; however, it is now only for catastrophic events. Recurring healthcare should be cash-based.

That brings us to the how? How do you start a cash practice? Several platforms on the market can help. Because I am a clinician and a software engineer, I created a marketplace that allows all the providers and me on the platform to state what they charge and the insurances they accept. In turn, I drive patients to the platform, and they get to choose a provider based on price, insurance accepted, distance from the provider, reputation rating, etc. The platform takes the provider to the discomfort of negotiating prices with patients. Furthermore, when the patients book appointments, they pay online, so I do not have to employ an army of people to collect my money. All the providers on Hutano have told me they love how the idea of a marketplace like this saves time and money.

Overhead is a real issue in healthcare. And it comes in two flavors, fixed and variable. Fixed overhead may be what it is. Meaning there is little you can do about it. Variable overhead, on the other hand, you can manage with technology.

I hear healthcare is complicated more often than I can count. But is it that different from other industries? Actually, not really! Consider this; there are five essential steps to accessing and providing primary healthcare. Finding a healthcare provider, booking an appointment, completing paperwork, receiving care, and follow-up care. If we figure out how to create technology that addresses the inefficiencies in each step, we will have fixed healthcare - at least primary care.

Traditionally, healthcare tends to mesh many technologies together and hope everything will work out. Inevitably we solve upstream problems without applying any thought to the downstream issues.

Let me give an example. Suppose you use Zoc Doc to automate and manage scheduling. Great! Your patients find you and book appointments efficiently. However, your waiting room is still packed with patients filling out paperwork. And yes! your patients still wait 45 minutes plus to receive care. At the end of the day, you are overwhelmed despite the efficient scheduling. So what is the solution?

Software should make our lives more efficient. Unfortunately, no software on the market addresses the inefficiencies in each of the five steps. Practice management software should make finding providers and booking appointments as simple as Zoc Doc. Furthermore, patients should be able to fill out the intake, attach pertinent medical documents like imaging and lab reports, then pay for medical services online. By the time a patient walks into the clinic, the provider should be armed with all they need to diagnose and treat. But why stop there? The information a patient just entered into their intake could transfer automatically into the HPI portion of the encounter note. That way, by the time a provider starts writing a note, the patient has filled out the chief complaint, medical and social histories, medication list, preferred pharmacy, and even their vitals if that is something they can do at home. So the clinician's time can be more effectively spent interpreting the objective measures in your tests and measures, assigning a diagnosis and treatment plan. It would be great if follow-up appointments were set up in the EMR and sent directly to the patient's phone. Lastly, it would be great for any outside referrals to be managed directly in the EMR, sending referrals directly to other clinicians with access to treatment notes upon acceptance or referral.

My point is that technology saves time and money because; and clinicians will not need to employ people to schedule and manage appointments. Instead, like an airline, patients can book and manage their appointments.

I created a platform three years ago that does what I just shared with you. Twelve other providers and I are on the Hutano platform, and the results have been encouraging. And, as a solo, cash-based practitioner, my time is no longer bogged down with administrative tasks. So, please visit us at Hutano.com to set up your free account, and let me know how I can help your practice be more efficient.

As a software engineer and clinician, I consult with other clinicians. Please let me know if I can be a resource for your practice. Ephraim Makuve, PT, DPT, MBA HA. www.hutano.com | also available on the Appstore and Google Play Store