In this episode of the Concierge Medical Marketing Podcast, host Steven Schwartz interviews John Hsieh, who shares his unique journey in the concierge medicine field. John discusses his background, his father’s successful concierge practice, and his aspirations to purchase an established practice. The conversation delves into key metrics for evaluating medical practices, the importance of understanding patient demographics, and the challenges facing direct primary care and concierge practices today. John also emphasizes the significance of marketing strategies and building an online presence to attract potential patients and business owners. The episode concludes with advice for aspiring entrepreneurs looking to enter the concierge medicine space.

Chapters

00:00 Introduction to Concierge Medicine and John Hsieh’s Journey
05:58 The Entrepreneurial Path: From Engineering to Medicine
17:17 Evaluating Practices for Acquisition: Key Metrics and Considerations
26:40 Challenges in Direct Primary Care and Concierge Medicine
38:06 Advice for Aspiring Entrepreneurs in Concierge Medicine
42:42 Introduction to Concierge Medical Marketing
42:42 Strategies for Growing Your Practice

Steven Schwartz (00:24)
Hello and welcome to the Concierge Medical Marketing Podcast. I’m your host, Steve Schwartz, and it’s truly my pleasure to have John Hsieh as my guest today on the podcast. And if you’ve seen any of our podcast recordings before, you’ll know that we take the time to speak with concierge and DPC physicians, those involved in the concierge medicine as a business, as an industry, as well as other professionals who provide services

that help Concierge doctors grow and thrive and succeed. And John’s got a really great, slightly different story, a slightly different point of view on the entire industry. So first of all, John, thank you for being my guest on the podcast today.

John Hsieh (01:09)
Well Steve, thanks for having me.

Steven Schwartz (01:10)
Awesome. You’re based in Michigan. Is that correct?

John Hsieh (01:13)
Yep. Based in, Lavonia, Michigan. it’s right just outside of Detroit.

Steven Schwartz (01:18)
Very cool. Very cool. As a kid, I spent a summer at Interlochen at the National Music Camp near Traverse City and just had a marvelous, marvelous time back when I was doing more in music and arts and stuff like that. but anyways, getting onto our interview today, John, again, you’ve got a great story and it’s a different point of view than my typical guests. And I’ll just really quickly introduce you and then let you tell your story.

your father is a very successful concierge physician with a growing solid practice and a huge waiting list. And he’s started from starting and moved up in his billing and his success and lowering his panel size is doing great with that. And he doesn’t need to grow. In fact, he’s looking to retire at some point. But your story is and I don’t want to get too much into it, but you’re in the process of actively looking to

purchase a concierge medical practice, is that correct? Okay, cool. So let’s do this. Before we get into any more than that, that’s where we’re going with our discussion. Please give our audience just a quick background on you, your family, your schooling, and what brought you to the point of thinking, hey, I’d like to actually buy an established concierge medical practice.

John Hsieh (02:18)
Yep, that’s correct.

Yeah.

Yeah. So I’ll kind of start from the beginning. First, you know, my dad’s a primary care physician and my mom’s a pediatrician. So growing up, I actually always thought I was going to end up becoming a physician. I went to school and majored in biomedical engineering with the plan of going to medical school. But around my junior year, I started shadowing physicians through my parents, know, pediatricians, primary care ER went through all the specialties from neurology, ENT, cardiology. And I actually.

really didn’t like the specialty professions. felt very pigeonholed. know, the example I usually give is when I was sitting in cardiology, everyone who came in was overweight or elderly. And the cardiologist said to everybody, you know, you need to eat healthier and you need to exercise. And then they would leave and he would look at me and say, I would give that person six months or I give that person eight months before their surgery is going to happen, or they’re going to come back in here and need to give surgery. And that kind of lifestyle didn’t really appeal to me.

I actually really enjoyed primary care and I enjoyed emergency medicine. But when I told my parents that they said, well, you know, the traditional healthcare system is kind of shifting. It’s not very rewarding for these doctors. They’re not being compensated the same way. They’re becoming more revolving doors and they’re referring patients rather than treating problems. My dad told me he used to deliver babies and you he used to do surgery as primary care. And they said, if you’re kind of considering that we would suggest going a different route instead of going.

which was kind of sad because they’re both doctors and they obviously support the field. And so I actually ended up pursuing biomedical engineering and I used to work as an engineer for lasers for Lasik eye surgery. I did that for one year and decided I wanted to get more into business. So I actually did sales and marketing for eight years after that before quitting my job. And when I quit my job around 2017,

My dad had also quit his job through his major hospital. and he actually decided he was going to open up a direct primary care practice. So while I was in between jobs, I actually helped him set up his practice. you know, I helped him with things that he didn’t understand as a physician, like QuickBooks and IT and EHRs. And I, since I was in sales, it helped with kind of the medical supplies, procurement. and then I actually ended up going to business school.

right after helping him set up. So to be honest, I wasn’t really thinking about working in medicine at that point, but I knew I wanted to do something entrepreneurial after kind of seeing what my dad was doing. So I just took every entrepreneurship class that I could find at my school. And one of the classes was entrepreneurship through acquisition. And I actually thought this was a class about how I’m going to acquire businesses and kind of bring them into a business I was operating.

or maybe how Google or Microsoft looks to acquire a business. But it ends up, it’s a class about how you as an individual can raise funding to look for a business that you would like to own and run and then acquire that business. And that really resonated with me. So that was kind of the first, you know, my first eye-opening experience to entrepreneurship through acquisition. And then kind of just ran with that after I found out about it. Maybe I’ll stop there to see where you want to take the conversation.

from that point in the story.

Steven Schwartz (05:59)
Yeah, it’s fascinating. I’ve really loved the idea of growing a business through your own blood, sweat and tears and starting something from literally nothing. Let’s make up a name, grab a domain name, create a logo, create a website, create a Facebook, create an Instagram. You can do this and it certainly takes longer because you have to build momentum. Then there’s the whole different method that you’re talking about is learning simply

How do I raise the funds? How do I select the right business and then literally buy that business? And then from there, take it whichever direction you want to go. And I think it’s fascinating. And so the direction I’m actually curious in hearing from you is this. And this is really for the physicians and practice owners who are listening to this podcast. What are you looking for?

as an entrepreneur in a concierge or DPC practice that you want to buy so that the physicians and practice owners who are watching or listening to this podcast can build their practice in such a way to make it more desirable that at some point in the future, someone’s likely going to want to buy their practice.

John Hsieh (07:20)
Yeah.

Yeah. So there’s some, you know, probably quantitative and qualitative factors there. I think the first one is the obvious is we look at the revenue and the EBITDA. do I need to define EBITDA for, so it’s earnings before interest tax depreciation and amortization. so if you look at your net income at the bottom of your income statement, just add in your interest tax and depreciation amortization and you’ll get EBITDA. so you’re kind of adding back.

Steven Schwartz (07:33)
Please do.

John Hsieh (07:50)
some value to your business. And really me, you know, myself and other buyers, what they’re really looking for is they’re just trying to see if this practice is big enough for an acquisition. Usually they’re looking for EBITDA to be greater than 1 million. That’s kind of probably the low floor. then revenue is not as important, but what they are going to judge is the ratio between those two. And in what I’ve seen for direct primary care,

They’re probably aiming for an EBITDA margin or ratio of like one to four. So they’re looking for 25 % EBITDA margins. And then for concierge, they’re looking for something between 25 % to 40 % in terms of your EBITDA margins. Now, if you’re not within those, I think the questions that they start asking, is it because you don’t have a full panel size? Is it that your pricing is a little bit low right now? There’s other factors that might explain

the difference and that’s okay, but that’s, those are probably the first most important numbers that they’re looking for. And then I think a third number that that’s really important and that they’re all going to be looking for is the, is your year over year annual growth? So they want to know your revenue. What has the change been for the last three to five years? And they want to know, has it been consistent? Have there been spikes in your revenue? you know, have there been downtrends in your revenue? A lot of people, especially in healthcare right now.

are specifically going to ask for your 2020 and 2021, and they’re going to ask how COVID affected your business. Any healthcare buyer wants to know how this business was affected by COVID. those are probably the top three that are the most important. And then the one that follows quickly after that is what we call churn. So churn is the percentage of your customers that are leaving your business each year. And usually investors are looking for businesses

that have 10 % or less of churn. So if you’ve got greater than 10%, that’s usually a red flag that there’s something wrong with the product or something wrong with the business. that’s probably a very, very important metric for doctors to pay attention to.

Steven Schwartz (10:00)
What items have you specifically seen in your efforts of researching a company to purchase have led to the most prominent churn issues?

John Hsieh (10:13)
Yeah, I think, well, when you’re early on in your practice, you just want any customer to come to your practice, right? Like you, you’re just trying to survive. So I think there’s going to be a lot of churn because you’re just trying to attract any customer, customer rather than maybe your target demographic customer. But I think as your patient base grows, you need to change your, your targeting. you’re a concierge medicine practice to the specific individuals who will get the most value out of that. I guess what I’m trying to say is.

you know, usually they’re attracting customers where this isn’t the right service for them. And that would be the primary reason. Cause most people, once they start using this, they love it, I would say. But it’s not for everybody. I guess, you know, an example is actually myself. You know, I’m 33 years old. I’m actually quite healthy. I actually don’t pay for direct primary care concierge cause I exercise regularly. I eat healthy. I really don’t want to pay for a service that I’m not using.

But I know that there are people with chronic conditions who need help managing that. And maybe that’s like a target customer you would want to. So I think that really you’d want to focus on like a target customer. And I would say not hitting the right target customers are like the number one reason for sure.

Steven Schwartz (11:27)
I know in my business with Concierge Medical Marketing and in marketing in general, we call it the avatar, kind of a high tech sounding name for the best example of what your customer or in a medical business, your patient looks like. So what are those demographics, age, gender, location, income, lifestyle, right?

So for example, a concierge practice may just want to cater to the executive health. We’re talking wealthy, busy business people, business owners, somewhere between age 30 and age 60, 65, who live within a 20 to 30 mile radius of your location, who are maybe $200,000 income or above.

John Hsieh (12:07)
Anyway.

Steven Schwartz (12:27)
and are generally healthy but don’t really have the time to fool around with waiting for a medical appointment. That is one very specific patient avatar. And a physician’s practice could literally just focus on people that match that criteria. Another could be seniors. Let’s say 65 and above.

male, female, or married couples that have some discretionary income. They may have generally healthy lifestyles, but they also may have some chronic conditions. And they literally want a much closer relationship with their physician to navigate and coordinate care as they age. So there’s another customer avatar.

When you’ve done your research, have you found different practices with that level of specific avatar defined?

John Hsieh (13:29)
Yeah. Yeah, actually just using my dad’s as an example, he probably just shotgun sprayed everybody across the entire age spectrum. but he has slowly worked his way more into what you mentioned, business owners. he’s actually worked his way into more families that don’t have, you know, young children. And for him, that was because there’s, there’s a lot of vaccinations for, for kids in the early years. And there’s a lot of issues that he was kind of referring them to.

a friend in pediatrics or his wife. And, know, he just said, you know, this is clearly, he used to tell me the one thing you never want to do is refer someone if you don’t have to. And he felt like he was referring people in that category. So he’s, edged away from that. And then he used to do the elderly folks, but he’s actually since moved away from that. He felt like there was a high intensive of care. They were taking up quite a significant.

amount of time and he did enjoy it, but it was taking away from other patients in the practice. And he decided, well, you know, there’s other people who want to charge more money to deliver that care to that demographic. And he referred them over there, but he said, you know, I’m going to charge less and I’m going to focus on it. A different demographic that’s utilizing the practice less often.

Steven Schwartz (14:46)
Right, I think it really just comes down to the physician and what kind of lifestyle he or she wants to have. Right? Do you want to have more patients charge less but be able to have more impact? Or do you want to have fewer patients, more quote, free time, if that even exists, and make more money?

There’s so many different ways to do it. And I don’t think that anybody is really going to know what their true desire is for their lifestyle until they really sit down, maybe grab a blank sheet of paper and a pen and just literally start making a list like a dreaming list. How do I want my life to be? How do I want to live my life when I’m not working? How long do I want to work before I want to retire and travel or

buy an RV or whatever it may be. You have to write that stuff down to get there. Go ahead.

John Hsieh (15:46)
Yeah.

I was just going to say, think what you said is extremely important because a lot of doctors go into direct primary care, concierge medicine. They fill their panel size. And then I think they have to ask themselves this question. Do I want to grow? Do I want to hire another physician or hire another nurse, bring on more patients, or do I want to continue with my current lifestyle? And in the case of my dad, which I think is totally fine, he said, I actually want to see less patients.

approaching my, you know, he’s in his late sixties and he would kind of want to work more towards retirement. He didn’t want to take on more responsibility. So he has decided to kind of remain a small practice. And I think that that’s totally fine. And there’s a lot of physicians who would enjoy that lifestyle. And then there are people who say, I want to build something great. want to share this with more people throughout the world. I think that this can change the healthcare system. And that’s, that’s great too. But I think that’s a huge decision to make. And I don’t think people should be pressured.

what one way or another, think that you just need to ask what’s right for you. What I will say from my perspective as a buyer is usually it has to be someone working more towards building a bigger practice. We kind of have to see that movement to think about it as an acquisition. If you’re just building kind of a small cottage business, then we probably wouldn’t look to acquire it. The main reason probably being is you probably want to retire and we’d have to replace you as a physician. That could be very difficult or detrimental to the business.

And the business size is very small and usually a buyer would want to start with something larger. So with one physician, it’s kind of hard to get to the size that we would look for.

Steven Schwartz (17:26)
Right, obviously, if the primary physician is the only physician and they leave, you’re paying them to buy the business, and then you’re paying another physician to do the work that the vacating physician did. And assuming those patients were going to stay, and they may say, well, my relationship was with Dr. Smith. I’m not that interested in Dr. Jones. So when you have a practice with multiple physicians and the owner wants to leave,

the remaining couple of physicians continue on as is, right? So that makes really good sense. One thing I’ll just mention in Concierge Medical Marketing, our marketing company, we have three different programs that we offer to our physician clients. And the first is transition, where physicians want to transition from a traditional insurance-based practice

to a concierge practice? How do you do the marketing for that piece specifically? The second is growth. Those that have a concierge DPC practice and literally don’t have the full panel that they want, how do we help them grow? So we have methods of doing that. But part of that one is, let’s say your first physician at the practice is already full and you have 400 people on a wait list. Well, what makes really good sense, assuming the physician wants to grow,

is let’s talk about bringing on a second physician and here’s 400 people, many of which would likely sign up with the practice and you’d have a full panel pretty much instantly. So that’s another method of growth. And then obviously when physician number two is full and you start building the wait list again, maybe it’s time to talk about physician three. And that’s where you get to a point where at some point you may have a five million or $10 million business buyout and the physicians can

you know, buy their boat and travel the world. The third and final program that we offer is related to nurturing existing patient panels, right? You want to stay in touch with them with marketing and with outreach and whatnot. So those are the things that we offer.

just curious as seeing different practices that you’ve considered, or at least researching for consideration of buying, you’ve probably seen these at different levels. And from your point of view for what your goals are, you’re telling me that you’re most interested in a practice that has more than one physician, maybe what

John Hsieh (19:51)
Yeah.

Steven Schwartz (20:02)
three to five, would that be safe?

John Hsieh (20:04)
Three to five is the target range of kind of what I’m looking for, for something to fall back on. then, like I said, I mentioned the EBITDA earlier. The reason why we look, a lot of people are going to say it’s hard to get to a million, but the reason that it’s there is, you know, there are always things that change and there needs to be some cushion if there ends up being, you know, maybe you a large employer that leaves your practice.

There needs to be some cushion for some mistake to occur. Otherwise, you could buy a business that sinks immediately.

Steven Schwartz (20:34)
Well, when it comes down to it, a concierge practice is a people business. You’re dealing with people. And if you’re building a business based on the relationship with one person and that person leaves, if there’s nothing else for the customer, in this case the patients, to keep them there, they’re going to start shopping elsewhere. It’s just human nature.

John Hsieh (20:42)
Yeah.

Yeah, it’s actually one of my favorite parts of direct primary concierge medicine. You know, if they don’t like it, they can go somewhere else. And I hope there’s another direct primary care concierge practice next door for an affordable price that they can go to.

Steven Schwartz (21:15)
Exactly. One of the data points that I noticed a while back was that concierge medicine is approximately six billion dollar industry as of 2023. And it’s currently forecast to go to thirteen and a half billion dollars by 2030. So in the next five years, more than doubling in size. And that literally blows my mind for that kind of growth.

There something special is going on here because businesses don’t typically grow that fast, especially when you’re in the billion dollar range.

John Hsieh (21:53)
Yeah, I’m really curious about that. I’ve, I feel like concierge has grown a lot more because it is the only available option, but direct primary care has been scaling quite quickly. I think in a lot of cases it’s more affordable and provides roughly the same service. And in some areas of the country, I’ve actually seen direct primary care actually taking market share away from concierge medicine. So I think there’s going to need to be.

a larger differentiation between the two. Cause you know, we call my dad’s practice concierge medicine, but he doesn’t take insurance. So some people would say he’s still direct permanent care, but he’s charging $5,000 per patient per year. So, you know, he’s clearly some form of concierge. and depending on who you are now that DPC is available, some people might move in that direction. So I’d be very curious as to where this growth in concierge and DPC is going to go. think both of them are only going to go up.

but I’d be curious if it accelerates that fast for concierge.

Steven Schwartz (22:53)
Yeah, we’ll see. And when I say concierge, I’m referring to concierge and DPC as an industry. think different people call the different types of practices same and different names. And there seems to be no official designation of, well, if you don’t accept insurance, then it has to be called the DPC.

And if you do accept insurance, then you have to be called concierge, even if you’re not charging five grand per year. You know, I think at some point we may find ourselves in a single phrase that encompasses cash pay businesses, whether you accept insurance or not. If you charge quote more, you know, as a premium fee than your competitors, I have a feeling it’s kind of going that way. But when it comes down to it, we’re talking about

the ability for a patient to have a closer relationship with their doctor, the ability to call or text their doctor more frequently, in many cases 24-7. And if someone wakes up in the morning and feels terrible, they can call their doctor and the doctor says, come on in, as opposed to we’re busy, go to an urgent care. Or if it’s very critical, go to the emergency room, call an ambulance. We want to make sure that we

as people in this industry are doing everything that we can to make this cash pay type more accessible health care available to as many people as possible so that it’s best for the patients as well as the physicians and the business owners that are providing the service. Would you agree?

John Hsieh (24:38)
Yeah, I would definitely agree. I would also say that, I wouldn’t even worry about the classification between any of these right now. Like you said, it just, it’s cash pay, but I will say that, you know, whoever ends up on top is the one who gets to create the definition. you know, whoever ends up on top at the end of this will decide what concierge medicine looks like. It decides what direct primary care looks like, but it will probably all be some form of cash paying like you’re, you’re mentioned.

Steven Schwartz (25:05)
Sure. You it’s funny as I talked to somebody about concierge medicine the other day and they, you know, put up a big wall. that’s that’s only for for rich people. You know, what about all the poor people that need care? And I said, well, you know, I’ve talked to some physicians who charge as low as $250 a month to have access to their to them 24 seven with a cell phone and texting. They go, really? $250. Yeah, I mean, it’s it’s available out there, you know, and

Certainly, many practices charge a whole lot more than that. But I think there’s something to be said about the industry and the perception of concierge, meaning it has to be expensive and it has to be only for Uber wealthy. And it’s not. It really isn’t. Now, certainly there are some practices that, you know, five or 10 grand or more per person per year are that’s out of reach for a lot of people. I get that.

but there’s certainly plenty of options that are still available and are a much, in my opinion, a much better option than traditional insurance-based.

John Hsieh (26:12)
Yeah, yeah, for sure. Especially if you’re a business owner, like direct primary care is far more affordable than your traditional healthcare.

Steven Schwartz (26:20)
Exactly. Well, let’s change our discussion just a little bit. In your opinion, what are the biggest challenges facing DPC and Concierge practices today? And as an entrepreneur and business owner in the near future here, how do you plan on addressing those challenges?

John Hsieh (26:40)
Yeah, I probably won’t talk too much about concierge because I don’t think there are many significant challenges. think the biggest challenge is probably just getting started. But I think most concierge practices experience pretty moderate growth and they fill their panel size and they, the biggest challenge is do I keep hiring more doctors and keep growing or do I stop where I’m at? But for direct primary care, I think their, you know, ideal customer profile is actually a business.

they’re looking for more employer contracts. And I think the biggest challenge right now is either one, getting the attention of business owners to utilize direct primary care for their employees or two, getting their buy-in, even if they can get that attention. I think those are, and I you’ve talked to a lot of drug primary care practices. Those are their two biggest barriers right now and biggest challenges. you, you, you, I think you were asking what to do about that, right?

Steven Schwartz (27:36)
Sure, exactly.

John Hsieh (27:38)
Yeah, I think, you know, as we, we’ve kind of talked about, know, you need to start building an online presence. Like business owners are present on LinkedIn. So like you need to start building some LinkedIn messaging and that can, you know, be posting on different articles you read throughout the industry, promoting yourself. if you do a podcast or a webinar, I would also suggest going to a conference and doing a panel if you could post that, but you need to gain some credibility because.

You know, you’re going to be doing some sort of direct outreach to these business owners. They’ll read your email or they’ll take your phone call. They’re going to go to your LinkedIn. They’re going to go to your website. And if they see a dead LinkedIn page and they’re not really, they’re still pretty unsure because direct primary care is kind of an unknown quantity right now to them, at least, you know, they might just say, okay, well, this doesn’t really seem like it’s that prevalent. I’m probably not going to buy into this. So you need to have some sort of established presence for, for when they do land there.

And that’s what I would do for awareness. As far as the buy-in, you could talk to Matt Orte from don’t feed the beast. or he does self-fund health. This is his business. And, he put together a conference where he brought together a large number of employers. forget how many it was. I want to say it was something like 70 employers. He got them all in a room and it was a huge educational session where he brought in, you know, former insurance providers to explain how insurance worked.

He brought in direct private care providers to explain how they operate, how different cash pays pay cash paid imaging centers work. and it was a huge educational conference that they put on for employers. I also was super important was he got current employers that are under their plans to show their data on their healthcare spend and show that their healthcare spend has gone down over the course of six or seven years or maintained over six or seven years. So.

They need to see real, tangible examples. They need to hear from tangible people that this is being used today. I think that that’s very powerful for driving buy-in for business.

Steven Schwartz (29:45)
Love it. I’m glad you brought up some of the marketing, obviously, through Concierge Medical Marketing. That’s our focus, is helping practices grow to the level that they wish and to nurture those existing patients through digital marketing techniques. So I totally agree with you that if you have a website that, let’s say, what needs to happen? You need to have a professional website, looks good.

easy to use, designed to convert, call to action buttons, a simple button in the top right corner with a phone number as well as a button that says schedule a meet and greet with our physician needs to be there. The website needs to be findable when people do a search on Google for concierge doctor near me, concierge practice near me, DPC office near me. These phrases that some people are typing into Google

need to land on the physician’s business website. And if it doesn’t work, if it’s not findable, then obviously you’re missing out on a lot of opportunity there. And this is a way of marketing to people who are actively searching for a practice. Well, what if people don’t even know that concierge medicine is a thing? They don’t know it exists. They don’t know anything about it. They’re not going to be going to Google and searching on it, right? So that’s where you need to do some

outreach of marketing or advertising to a passive audience. For example, as we talked about, if your avatar is busy executives age 30 through 65 who live within 30 miles of your office and either own a business or a C level employee of a company, then you can display ads to those specific people.

on Facebook, on Instagram, on LinkedIn, on YouTube, and on CNN and Fox News. All these different places on the internet are available for advertisers to put their message. And because these platforms know essentially an infinite amount of data about each of us, they know which ads will resonate with who we are. For example, an ad coming at me.

John Hsieh (31:39)
Mm-hmm.

Steven Schwartz (32:06)
early 50s, male, lives in this area of Florida, business owner. I’m going to see ads that a 65-year-old woman who lives in Alaska may not see. We’re all different because of who we are and our backgrounds and avatar details. So I’m glad you brought that up. But yeah, good website, findable advertising, LinkedIn, digital ads. One of the things, too, that I think

a lot of businesses know about but don’t implement is the concept of retargeting ads. I like calling it reminder marketing. And just the idea when you go to a website and you look at a product, let’s say you want to take the kids out on a kayak on the lake or the river near you, you look at kayak websites and then you leave and you go to dinner and you come back to the computer the next day. And then what do you see on the websites? Ads for the kayak, right? A couple of years ago when this started happening,

John Hsieh (32:58)
Yeah.

Steven Schwartz (33:04)
People were kind of freaky. It’s like, my gosh, is Google looking down my shoulder? Is Big Brother watching me? All this kind of silly stuff. It’s very simple technology. You showed interest in, in this case, let’s say a kayak. So let’s now show ads for that kayak on these different networks of websites that have space for advertisements. You show the same ad over and over again. It reminds your customer that you had interest in this thing, encourages them to come back, encouraged

click, maybe get a coupon or whatever the story might be. But we do know as marketers that people typically need to see an ad message six or seven times before they make a buying decision and certainly before they decide to dig in more. And so with technology, makes it really easy to do this. all that being said is that if a person visits a concierge medical practice website and that practice wants to grow,

They should be doing these retargeting ads so they can then display ads to those people who’ve shown interest in the practice. You with me?

John Hsieh (34:08)
Yeah. I think one thing you said that that’s super important that I wanted to just highlight is you said that it takes six or seven kind of interactions. That is so true. And like people aren’t going to see your email the first time or your cold call or your advertisement and say like, I want to go meet a direct primary care physician. It’s, it’s going to take time. It’s going to take repetition. And like that’s just like, you never see something for the first time and decide you’re going to go buy that.

And I think that that, cause I think people are discouraged where they will send one or two emails to a business owner and business owner doesn’t get back to them. Business owner probably receives a hundred emails in a day. and it’s just one there and maybe it didn’t catch their eye, but you, even if it did, they probably glance at it quickly. You need to hit them. You know, multiple times. think what you said seven is what usually is how many times it takes, which is why you should aim for like nine or 10 interactions.

Steven Schwartz (35:03)
I agree. Yeah. And the challenge with email is that we’ve all become so jaded to getting flooded with email messages that we now have not just an inbox, but we have like three other tabs in the typical Gmail. Right. You know, the promotions and the socials and whatever the other one is. And messages typically newer ones end up in the other boxes instead of the inbox. And if someone

doesn’t go through and check those, they’re not going to see those ad messages. So in marketing, we call it an omnipresent approach and literally omni everywhere, present, being present. So if we’re able to quote, target a person who’s shown interest in our practice with ads on Facebook, with ads on Facebook,

You Fox News and CNN.com and Weather Channel.com and a host of thousands of other websites that we visit emails, even text message marketing, assuming that the lead has provided us their cell phone number and agreed to receive text because never, never send emails and text to people who haven’t specifically requested them. gets you in trouble. But there’s so many different ways Facebook, Instagram.

all these different places where you can show your ad message so that you can get closer to that six or seven touch points or exposures per lead. And the idea that these people say, wow, I did some research on concierge doctors. And man, I’m seeing Dr. Smith over and over and over again. They really seem to have their stuff together. Yeah, let’s do a meet and greet with him and see what’s going on. That’s the kind of thing practices need to do.

John Hsieh (36:29)
Mm-hmm.

Steven Schwartz (36:55)
If they want to grow, right? If they want to grow. Now, granted, like your dad’s practice, he’s full, big waiting list. Does he need to do this? Not really. You know, he’d be a more of a case of nurture where, you know, our third package where in this program people get get touched with an email or a newsletter once or twice a month, a text message once or twice a month, seeing some miscellaneous ads.

John Hsieh (36:57)
Yeah.

Steven Schwartz (37:22)
Maybe a quarterly wine, shrimp and cheese event where we get everybody together and we learn about some medical topic or some lifestyle topic. Things that help a patient of a practice feel wanted, to feel loved, to feel appreciated. So everybody’s a little bit different. Man, I’ve really enjoyed this discussion. I think we’re running out of time here. As we try to wrap this up here, John,

John Hsieh (37:42)
Yeah.

Steven Schwartz (37:52)
What advice would you give to other entrepreneurs who are considering doing what you’re doing? In other words, they want to potentially buy a concierge practice one day. Based on your experience, what would you give them as advice?

John Hsieh (38:06)
Yeah, if they’re trying to do what I’m doing where I’m looking to acquire practice, then what I would tell them is go talk to other. There’s actually probably more individuals than you think who have raised funds like I’ve to go buy a business. It’s actually, for those who don’t know the official term, it’s called a search fund. And I think nowadays there’s about a hundred search funds raised every year in the country. And if I were you, I would go out and I would…

talk to everybody who’s raised a search fund. Not every one of them is looking to buy a concierge practice. Some of them are buying HVAC businesses, some of them are buying health tech businesses, some of them are in HR, some of them are in plumbing. But I would just go interview each one of them to find out what the fundraising process looks like, what kind of background investors are looking for, what kind of businesses they’re looking to buy, what it looks like to… All I do all day is email and cold call and…

you know, business owners or I go to conferences at which they’re present, try to meet as many as possible. So, you know, learn, learn about what that, that experience looks like and what it looks like to kind of buy a business and try to decide if that’s right for you. I would also try to find people who, you know, were successful in buying a business and had great success. People who bought a business and actually did not have success post acquisition, people who failed to buy a business with the funding that they raised.

You know, I think you should interview every, you know, everybody for all outcomes to make sure that this is the right path for you is what I would suggest.

Steven Schwartz (39:36)
I love it. You’ve got such a wealth of information based on your experiences and your personal journey here. And as you still continue to research and talk with folks and try to find the perfect practice that you wish to purchase, there may be people who are listening to this podcast who are considering selling their practice in the next couple of years.

If someone would like to communicate with you directly, maybe to schedule an appointment to chat, to get to know you a little bit closer and what you’re looking for more specifically than we got into today, how would you like people to get in touch with you?

John Hsieh (40:17)
I’d recommend they reach out to me via email. So my email is just you can just look up Berg Lake Ascension.com and that will actually be my website. My contact information should be on there as well.

Steven Schwartz (40:33)
Great. And that’s Berg, like B, as in boy, E-R-G. OK, like iceberg, but without the ice. Cool. Well, this has been really great. We talked a lot in our discussion today about digital marketing to help concierge practices grow and to nurture existing patients. And for anyone listening to the podcast who wants to grow,

John Hsieh (40:38)
Yes, that’s correct.

Steven Schwartz (41:01)
I’ve written a book called The Definitive Guide to Winning with Digital Marketing for Concierge Medical Practices. And this book is completely free with my blessing. All you need to do to get the book is visit our website conciergemd.marketing and scroll down the home page a little bit. Look for a copy of the book. And there’s a spot where you can enter your email address. Click the submit button and our system will send you an email where you can download the PDF of the book.

read it with my compliments. And please, if you have any questions whatsoever about anything that’s in the book or anything that we’ve talked about today or on our other podcasts, you’re absolutely welcome to reach out to me personally. My phone number is 772-304-2420. And you can also text me at that address or that number as well. Happy to answer any questions that you may have. So John Hsieh.

It has been really my pleasure speaking with you today. Thank you for taking the time and sharing your story and sharing amazing insights from your path with our audience. Yeah, truly my pleasure. And perhaps we can reconnect for another podcast interview in six months or a year or whatever and see how things are going. And perhaps you’ve purchased a practice by then. I’d be really curious to see how the story continues.

John Hsieh (42:12)
Thanks for having me, Stephen.

Steven Schwartz (42:29)
on the post-acquisition situation.

John Hsieh (42:33)
Absolutely.

Steven Schwartz (42:34)
Very good. Hey, have a great day for everyone listening to the concierge medical marketing podcast. We appreciate you have a great day and see you next time.