Patient discovery paves the way to practice success

By Regina Druz

As part of our exploration in applying Lean Start Up model to integrative practice, we will focus on patient discovery, the most important and critical first step of practice development. Completing the patient discovery phase successfully is a major pre-requisite to patient validation, patient creation and practice growth, which are the building blocks of the Lean Start Up model for integrative practice.

The patient discovery phase is focused on finding the prospective patients who are your “leaders”, a group who have an understanding of and are in need of the services you are offering. These early patients are your essential target patient group, and a foundation to your entire practice model.

The patient discovery phase focuses on two objectives:

1. Identifying your target patients.
2. Proving your services meet their needs and provide value.

This phase is a structured development of your understanding of your patients and their specific issues in the context of your services. Prospective patients will form your initial target group share a number of characteristics. The most important of those characteristics is a patient’s own perception of their need for your services, and degree of emotional discomfort that not having your services causes to a patient.

Prospective patients seeking integrative care likely have gone through several milestones in seeking help for their specific health condition or concern. As is almost always the case, they may have visited traditional practitioners and received care based on a standard approach. Then, falling short of their goal or perceiving that their needs are not addressed, these patients have attempted to develop their own strategies.

Many patients today are more informed and may have done their own research on integrative medicine practices, incorporating some of these into their daily routine. Some may have designed a homegrown solution to their problem, devising their own nutritional, exercise, or supplement regimen. The group that you need to focus on is the one who did not succeed as much as they anticipated with their own solutions and has a will and a budget to go to the next step, your services.

These prospective patients are aware that they have a problem, and want this problem solved, but have fallen short when they tried to address it on their own. Place value on your services that outweighs the price concern. When identifying these patients, consider creating patient personas, including budget and lifestyle characteristics.

To help you get started, do this easy exercise. Think of a patient that you have seen in your practice who successfully engaged with you and your practice services, preferably over at least a three month period of time. If you are not seeing patients yet, think of a hypothetical patient that you feel is likely to seek your services. You do not need to be very detailed; a basic understanding of your patients will suffice. On a piece of paper, write down your answers to these four questions:

1. What problem or problems was this patient aware of?
2. Did they pursue a standard care solution?
3. Did they develop a home grown or a substitute solution?
4. What need did they express, and allocated a budget to for a professional solution option?

Then, expand on your answers, filling out patient characteristics for patients who are similar to your patient example based on your existing patient group. If such group is not currently available, come back to your exercise once a few more patient encounters take place.

Once the target patient has been preliminarily identified, the practitioner must reach and engage with them. Community talks, flyers, a website, blog posts, and other forms of educational marketing are common tactics, however must be geared directly towards the patients likely to use your products and services. This doesn’t mean adding additional features or services—start small and focus on positioning a limited menu to the correct audience.  This strategy of “getting out of the building” is an essential component of the patient discovery process. Once you return from your “out of the building” activities, you will be armed with a new knowledge of the patient characteristics that fit your initial service offering. Notice that in this stage, you are not marketing your practice. Instead, you are gathering knowledge about your target patient group, and defining your patient-services fit.

Have a clear understanding of your products, services, and what they offer. When identifying your target patients, you may find that some services are more sought after than others, and therefore you may choose to focus on those services until your practice is more established. Figure out the essential components of your service provisions. Figure out which patients are attracted to these components of your service provisions, and are willing to participate in your service offerings. When you do that, you have discovered your target patient group.

In my initial stages of opening an integrative cardiac practice, I was uncertain as to what type of services my practice would provide, or the types of patients I would attract. I offered advanced laboratory testing, genetic evaluation, and lifestyle intervention based on nutrition and supplementation. I brought in a health coach to expand into nutritional consultations, but wasn’t seeing patients embrace the health coach enthusiastically, even though her service was already included into the visit fee.

Based on experience in large academic medical centers, I knew patients had an interest in services from nutritionists, registered dieticians, and health coaches alongside their traditional physician services. Additionally, from my perspective as a functional medicine practitioner, I understood the most successful model appeared to be a collaborative referral partnership between a medical practitioner, typically a physician, and a nutritionist or health coach.

My goal was to attract patients who had known cardiac conditions, and potentially had cardiac procedures, who were already receiving traditional care, and to offer these patients a holistic cardiology approach. Since I hadn’t completed my patient discovery stage, and didn’t evaluate what my patients’ service fit was, I had a very vague idea of what I should be offering.

I soon discovered, after observing patients and talking with them during follow-up visits, that getting dedicated and expanded nutrition advice was my not my patients’ main concern. They were looking for a holistic cardiology service in my practice specifically to avoid additional cardiac procedures or decompensations and reduce or eliminate medications such as statins. Many already received or adopted a good nutritional advice, and did not place high enough value to pursue it in my practice.

Patients who were referred to a health coach, while they did like the interaction, didn’t feel that it was specific to their needs, and so majority of them quit after a couple of health coach visits. I subsequently scaled back the health coach services, and focused on my original services to help patients avoid procedures and come off medications through application of advanced laboratory and genetic analyses, refining the nutritional supplementation, and building stress resiliency. I steadily emphasize this on my website and through educational offerings, blogs, and patient cases, and ended up formulating a program specifically reflecting on this approach. In a about a year, the practice grew to attract exactly the types of patients I was envisioning, and the revenue increased steadily.

A successful patient discovery phase will set the practitioner up to continue to grow their practice and, when the time is right, expand their services. Services will grow as your patients grow and their health improves. Communicate to patients your shared vision of what their health will be. You have a mission, and a set of skills to accomplish this vision, and your services are distinctive and specifically positioned to make it happen in the way that engages new patients, expanding your target patient group, and providing opportunities for a better fit.