In this episode of the Concierge Medical Marketing Podcast, Dr. Aida Khanum shares her journey from traditional insurance-based pediatric practice to a Direct Primary Care (DPC) model. She discusses the challenges and rewards of transitioning to DPC, including the impact on stress levels and profitability. Dr. Khanum emphasizes the importance of community education and personalized marketing strategies in attracting new patients. She also offers insights into consulting for other physicians looking to make similar transitions, sharing valuable lessons learned along the way. The conversation concludes with advice for new physicians considering a DPC model and the significance of maintaining a sustainable practice size.

 

Chapters

 

00:00 Introduction to Concierge Medicine and DPC
06:16 Transitioning from Traditional to DPC Practice
12:01 Challenges in Transitioning Patients to DPC
18:11 Advice for New Physicians Entering DPC
24:02 Flexibility and Personalization in DPC Practices

 

Download Brochure

 

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 you along on our discussion today. I am so thrilled to speak with Dr. Aida Khanum. Aida, thank you for being with us today.

Aida Khanum MD (00:38)
Thanks for having me.

Steven Schwartz (00:39)
Truly, my pleasure. And we met recently through LinkedIn. We’ve had a great conversation before hopping on our recording here. And I just really wish I had started clicking the record button before because you had so many wonderful things to say. What I’d like to do is let’s start with your background. And your practice is in pediatrics, which is super exciting, working with kids as your specialty.

but not just kids, but kids in a DPC concierge arrangement. So could you please share with our audience your background? Why did you want to become a doctor? And then what led you to DPC as the arrangement or the structure of your business?

Aida Khanum MD (01:27)
Yeah, well, thank you for having me. So yes, I started, I guess I wanted to be a doctor since I was little. I didn’t have any physicians in my house. My dad was a lawyer and my mother was a teacher. And I think just growing up, it was one of the things that was a very respected profession and I loved kids. And so I said, you know what? I think I want to be a pediatrician. Yeah. So I kind of knew that from a very young age. And I had an uncle who was a mentor. And so he kind of guided me.

through my schooling and then deciding to go to med school. So I did my med school abroad and then decided to come to the US for my residency and did my fellowship. So I did my residency in New York, Syracuse, then came down to do my fellowship here at Baylor in Houston and got a master’s in public health at the same time because I had an interest, I speak a few languages. So I had an interest in international health but then I met my husband.

And he said, well, yeah, traveling the world is going to be a little hard. So let’s just stay and make your little international world here. So Houston is a great city for that. yeah, so then I stayed and went up in the workforce and then opened my own practice about 10 years ago.

Steven Schwartz (02:35)
Wonderful. And the practice that you started 10 years ago, was that a traditional insurance based pediatrics business?

Aida Khanum MD (02:45)
That’s right. Yes. So I did. So I’ll tell you a funny thing. So when I was starting my practice 10 years ago, I actually went to my CPA and when we were kind of coming up with the business model and the first thing she said to me was, why are you taking insurance? And I was like, huh? And she was like, you know, why are you taking insurance? She’s like, don’t take insurance. Just go and, you know, do like a cash base model. Don’t get into this whole thing. And, know, I…

only knew the insurance world and there was nobody else doing it. I think there was one practice that she had just started and was trying it, but that was it. And so I was like, I think I was a little nervous. And I said, you know what? This is the first time I’m doing it. Let’s just go with what everybody else is doing. And so, yes, it was a insurance-based practice that I did start 10 years ago and then learnt a lot of things in those eight years before when I…

decided to make the switch to DPC Concierge.

Steven Schwartz (03:40)
Now what items specifically caused the turning point to say I can’t do this anymore or I don’t want to do this anymore. I have to get rid of dealing with insurance and DPC is something you’ve heard of. How did that happen?

Aida Khanum MD (03:57)
So my colleague who had actually started exactly a DPC practice 10 years ago, I’d heard about her and I kept hearing and she, we’d sort of talked a little bit on and off. And, know, again, it was hard work for her, but what happened with my practice, I was a solo practice. you know, for the first time had to deal with insurance companies and, you know, had to run a business along with seeing patients that was wearing two hats and never realized, because I think until you do it yourself, you don’t realize.

how broken the system is. And so there I would be seeing patients trying to grow my practice, having to generate more, well, see more patients over the years to generate the same revenue or less. Because every year there’s no negotiating power, insurances kept dropping what they wanted to pay for the same thing or fight on everything. I mean, the time that you spend and invest trying to get…

dollar amounts that just for the basic things to be covered to cover your overhead was just becoming insanely ridiculous to the point where I kind of forecasted and looked forward ahead in time and said, you know what, at this rate, the level of care that I tried to provide. for the, even though I took insurance, was providing concierge level care. My patients got same day appointments. had 20 to 25 minutes. I mean, I didn’t ever push anybody out. So they got to talk to me, ask me the questions.

they got to access us. You know, I mean, it was that level of care without having a membership fee on it until I was like, OK, now either I have to stop providing that care and see 5000 patients and double book, triple book, refuse appointments, push them to the urgent care or make a business model decision, which is what I decided because I went into medicine. I like to know my patients. I like to have a relationship. I like them to feel like this is.

a place where they feel they’re in a safe space. And I know I have three kids of my own. When your kids are sick and you’re calling, first if you’re not able to get a hold of your doctor to even talk to them, that’s terrible. And then not getting an appointment and then having people say come back in three days, terrible. I wouldn’t wait. I wouldn’t wait. I don’t know how anybody does wait. And I was like, no, I can’t do that. And so, yeah, that’s what made me make that decision and leap to changing it over to a concierge DPC a year and a half ago.

Steven Schwartz (06:15)
nice. Tell our listeners how has your stress level changed? How has your profitability changed just on those items?

Aida Khanum MD (06:28)
So stress level, think it’s not easy. I think when people say it’s, you know, just jump on and do it, I don’t think it’s easy. I think you still do need to do a work beforehand. It’s a different work, a different level of work. So the stress is different, but it’s not patient care stress, which I think was nice. You know, so I have the patients that I have, I know them, they literally feel like they’re part of my family. They reach out, it’s just such a nice.

fulfilling experience. think that has been the wonderful part about it. Because there’s price transparency, it’s not transactional. know, money is not, and you should see how people react. I mean, they’re like, they’re always going to the front and saying, do I owe you anything? And we’re like, no. And they’re like, I really don’t owe you anything. You spent an hour with me. And I’m like, yeah, no, you’re good. You’re good. I mean, it’s just hard for them to believe, but it’s so nice because they are just so.

appreciative and their health outcomes are so much better. So I think from that perspective, it’s been amazing. But on the other side, with the stress of trying to grow the practice, I think that is hard work. I think you have, because it’s about educating the community. I think people don’t know what we do. And so the automatic reaction is, what? I don’t know what this is. This is something expensive. I don’t want to hear about it.

without really realizing what it is that we’re offering. And I always tell parents, say it’s concierge level care at an affordable price, at something that’s often less than what you’re paying right now with very poor access. So I think from that perspective, I think it has been hard work, but learning and growing and great. I wouldn’t change anything.

Steven Schwartz (08:10)
Excellent. Are you at a full panel size now?

Aida Khanum MD (08:13)
No, so I am still growing. When I transitioned, I had patients that joined me directly. And as I said, remember I said was providing concierge-level care without a cost.

So for a lot of my families, they had never been in the real system and didn’t realize what it was like. And so when I changed the business model, people loved the practice and they were like, but now I have to pay. then so there was that thing in their head and I was like, it’s okay. I said, you go ahead and try it out and see what you want to do. And so I’ve had people come back. There were people who joined, there were people who left and came back.

And then it’s also been kind of going out there and trying to educate people and bring on new families. And I offer a meet and greet because I always want to make sure people understand what I have to offer and I want to make sure it’s a good fit. So yeah, so every month I open up spots to bring in more families. So yeah, not full yet, but getting there.

Steven Schwartz (09:10)
Wonderful. What methods or techniques of marketing, digital or otherwise, did you do that you found were helpful, successful in bringing aboard new families to your practice?

Aida Khanum MD (09:24)
So I think the one thing that I learned relatively quickly was that it is me. I am the product, right? So if, you know, the old style of, I think sponsored marketing and stuff doesn’t necessarily work in this model, know, networking, creating relationships with the community, I think has been a big deal. People who join are really people who kind of want you.

So I think that has worked, creating a website. I think a website that is targeted towards telling more about who you are as a person. I think if you go to a traditional practices website.

It’s usually just information and things like that. I feel like, and this is something that I learned maybe like six months or a year into it, I sort of revamped my website to make it more personal, tell them a little bit about me as a human being. So kind of create that personalized touch so they feel like they’re coming to me as a person, not pediatric part concierge pediatrics company.

And I think that was a big thing. And then social media, I do a lot of social media education, which I love doing. I really like educating the community. It’s all practical stuff. It’s not really medical stuff. But I think just being on social media and I’m on all the platforms has helped, I guess, make people sort of validate or sort of make me a presence. then sort of then when something works, when something clicks in their head, then they just suddenly are like, you know what, I think.

this person is for me, know, kind of make it more personalizing. So I think those are the two things that I kind of felt helped.

Steven Schwartz (11:02)
Excellent. I’m sure you get plenty of referrals from existing patient families who, as they say, know, like, and trust you. And so they want to refer you to their friends and family. I did watch some of your social media videos and you’re just so personable and so charming. I just, I think there’s something about using video through the internet as a way of helping connect people through, you know, the screen.

Aida Khanum MD (11:06)
Yes, 100%. Yes. That’s right.

Steven Schwartz (11:31)
But in doing so, you’re building a relationship going from somebody who’s never heard of you before or maybe never heard of DPC or concierge and starting to drop these beautiful, wonderful little videos that are providing education on some topic relevant to a person’s health or their family’s health or the child’s health, whatever it might be. Obviously not providing, you know, personalized care through a video, but

but as a way of literally sharing great information. And in doing so, people see your personality. People see that you’re a person that cares. when, what’s that phrase? People don’t care how much you know until they know how much you care. I’ve heard that one many times over the years and it’s so true. And so using that video the way that you do, I think is so powerful and so appropriate.

Aida Khanum MD (12:18)
That’s right.

Steven Schwartz (12:28)
to help you grow your practice to the full panel that you’re desiring to reach.

Aida Khanum MD (12:32)
Thank you, that’s very sweet of you to say.

Steven Schwartz (12:35)
Sure. Did you find it challenging to transition existing families to the DPC model? Did you get a lot of pushback or was it… How did that go?

Aida Khanum MD (12:49)
So, you know, I think it wasn’t pushback. think it was more, I tried to educate. So I really spent a lot of time talking to all my families. I did tell them what I was going to do and why I was going to do it. And the ones that, there were people that were like, I don’t care what you’re doing.

We love you, we’re not moving. So they just were like the easy sell. No, it wasn’t even a sell, but it was just a, you know, they would just transition without any problem because they really believed in keeping their care with me and me looking after their kids. The majority, however, I think, as I said, everybody is so, you know, I pay for insurance, then why should I pay for something else was a big deal. I think there wasn’t much movement. This is about a year and a half.

Now I’m hearing a lot more and there’s a lot more in the news and a lot more dissatisfaction with all these surprise bills, not necessarily surprise bills, but facility fees and all these extra costs that people are now starting to maybe deeper dive into their insurance and realizing that really insurance is for expensive things and not for your day-to-day care. You’re still going to pay for it and yet you’re not guaranteed anything and that this might be a better investment, is definitely a better investment for

for so many reasons. But I think, you know, really kind of some, think there was, as I said, because I was kind of practicing this level that the percentage of patients that I thought would switch over.

was not as high as what a lot of people assume would happen. And it’s really just because that’s the level of care I was providing. And then I had people that went out and then realized they weren’t getting appointments or were never seeing their pediatrician or were going to the urgent care half the time and it was costing them a hell of a lot more money. Sorry, I don’t know if I should say that, but so they kind of then reached back.

back up to us and join the practice. And I do give them first dibs. So, you know, when I open up spots, it’s sort of to try to control how many patients, because I want to be able to offer this level to everybody. And, you know, I don’t want to offer, I don’t want to tell them what to offer something and I’m not able to come through with it. so it’s been a transition. It has been a transition, but I think it’s just really more the education.

Steven Schwartz (15:07)
Right. You also mentioned before we got on our recording that when you were transitioning your traditional insurance-based pediatric practice to a DPC practice, that you really didn’t have a mentor or a coach to help walk you through that process. You kind of figured it out with, as they say, blood, sweat, tears, and elbow grease. And you figured it out and you’re making it work.

You mentioned that you’ve helped a few other physicians transition their practices as well. And this is actually turning into a new business for you. Can you talk a little bit about how you can now help physicians transition their practices to DPC?

Aida Khanum MD (15:53)
Yes, so you’re very right. So when I actually made the change in the transition, it was all, I tried to look and find and see if there was someone else who had done it. There was nobody. I wasn’t able to find anybody who had actually transitioned. There were a lot of people who started from scratch, which is kind of different versus when you’re trying to transition. Because again, when you transition, the goal is hopefully to be able to get some of those families to your new practice. And there is a way to do it.

I kind of had to learn on the fly and retrospectively, I wish I had done certain things differently. And so I have a whole, and that’s what I’ve been trying to do with a couple of, I’ve had a few physicians, pediatricians across the US reach out to me to get information. And so, yes, I have started a consulting for that where I kind of created a roadmap for them of what to do for your assessment of your current practice, how to assess it.

how to plan going forward and then walk through the process of the transition and what it should look like. And again, the hope is to not have other people make a lot of the mistakes that I made, which would make that transition so much easier and save you money and time and energy.

Steven Schwartz (17:06)
and stress.

Aida Khanum MD (17:07)
stress, big time.

Steven Schwartz (17:09)
One

is a big one. So often we talk about hindsight is twenty twenty. If I only knew then what I know now, I could have, you know, bypassed that landmine and that problem and that mistake. Are you willing to share maybe one or two things, stories that if you knew then what you know now?

you would be in a different position now. Any stories like that you might want to share?

Aida Khanum MD (17:42)
So one story, one I would want to say is the people that you think will stay with you are usually the ones that won’t. And the people that you least expected to stay when it costs them money on a monthly payment, stay. So I had a lot of Medicaid patients. So my practice was like 60, 40 commercial Medicaid. And I have had Medicaid patients who chose to stay with me.

because for them it was like, and I’m a Medicaid ordering referring provider, so they can stay with me, they pay me the monthly membership, they do not, that’s not something they would want to ever give up. They were like, I would rather come here, I know I get things done, it saves me so much time. These are people who usually have small businesses. So I think that would have been something I would have liked to have realized because again, you don’t realize it and you don’t want to take things personally.

I think that’s a big deal because sometimes you you’re like what? You kind of start to look at it when people are like well you know I don’t know and you’re like my god I looked after your kids for each I mean were you dissatisfied and it’s nothing personal it’s really nothing personal it’s just everybody looking at their own situation and then seeing what they need and that’s it and I think that sometimes is another way because that adds stress to you.

when you’re not aware of who may or may not and your expectations are there and that can kind of add stress and make you have negative thoughts and self-doubt, which you shouldn’t have. So I think that would have been something that I would have liked to have had a better handle off at the beginning when I was starting. And I hope I can tell other practices deal with that.

Steven Schwartz (19:31)
Exactly. So for physicians who are listening to this podcast, sometime into the future, they might say, huh, now I know that I’m not the only one that’s going through this or, you know, don’t make a big deal about if the people that I thought were going to stick around don’t and vice versa. What about people who are finishing residency and their training and they’re ready to start a business?

Aida Khanum MD (19:50)
Mm-hmm.

Steven Schwartz (19:58)
Would you encourage them to jump straight into DPC? Or would you encourage them to maybe start a traditional insurance-based practice first and then transition later?

Aida Khanum MD (20:10)
No, yeah, I would just tell them go into DPC directly. There’s no need. There really is no need. It’s, you know, DPC, Concierge, it’s, you have to, you can keep your overhead really low. I think that’s a big deal. You wanna keep, you can start very small. You are only gonna be a small practice. So your overhead is really low. Create those relationships. You have time, as long as you have. So the thing is, it takes a while.

to grow. you do need to have that financial, I would say nest or something, you need to have some money before you can do this. So depending on your financial situation, I think that is important to kind of look at if you can sustain yourself for a couple of years. As I said, there are people that start and it just takes off.

depending on where you’re at, depending on your reputation. And then there are others, which is like the general, it takes a while and you kind of have to get that momentum growing. And so you do need financial, you if you are the sole earner and things like that. So people often will start at EPC, but then work, do other things on the side to supplement the income. I think that is a real situation. But when it comes to investing your time,

in a practice, would say just do it DPC, spend your time, get those relationships, build the practice. It is way better and way, way better for you, for your patients, for your lifestyle. And you can do other things. mean, you know, I, in my practice, I do autism evaluations, I do ADHD evaluations. So patients do not need to be a member of my concierge. I basically am like the…

problem solver. So I look in my community and I’m like, okay, what issues are they having in healthcare? And then I’m like, I can help people with that. Yeah, it costs, it’s a cash based practice. But again, the perk is it’s affordable and there’s no wait time. So for those people that that’s what they want and that’s where I come in and do it. So I think just being creative, I think that’s how you’re do it. But yeah, that will be my advice. Don’t waste your time.

Steven Schwartz (22:21)
I love it. What size do you think for your business is a reasonable panel size so that you can still provide the excellent concierge level care without stressing out but still making enough income to cover all of your expenses and obviously have your personal income grow?

Aida Khanum MD (22:41)
So I think that totally varies based on your pricing. So I think there are practices that are small. Like I know a couple of micro practices here who are for adult practices and their pricing is more, not that much more, but it is more expensive per month. So their panel is smaller. If your pricing is lower, then your panel tends to be a little larger.

But again, I think on average they say up to 500 is something that you could do when you’re offering all that you’re offering. But it depends on how you educate your families and what you tell them and what expectations you set for them. And then in my practice, I actually invite people in. I make sure that they kind of understand, because it’s like an interview that they’re giving, they’re taking my interview, but I’m also taking their interview to make sure that it is a good fit.

Because I would never want somebody to think I’m offering something that I’m not or bring on a family that doesn’t fit in. Because I don’t take non-vaccinators. And so I would never want to ask somebody to leave. I’m like, everybody has their own choice, and that’s totally fine. for my practice, that is one of the things that I do. And a lot of people choose to join my practice because they know that we don’t have non-vaccinators in the practice to keep the kiddos safe. Because I have some kids who have.

health conditions that cannot get vaccinated. So their goal is to try and make sure that those kids also stay healthy. So I think things like that will determine. So your pricing may determine the size of your practice and what you’re going to offer. And again, how much of the other stuff that you’re going to do that you can make your practice size even smaller. So you can do whatever you want. And they always say, you’ve seen one concierge DPC practice, you’ve literally seen one. Because every single one of them does it differently and does what works for them. And you know, the hours. Yeah.

Steven Schwartz (24:29)
Yes, I’ve seen that quite a few times as I speak

to different physicians, know, some, you know, which maybe call concierge and still do accept insurance in some levels, along with their annual fee, other practices that say no insurance, not at all, not touching it with a 10 foot pole, others that provide additional services at discounted prices, different in-house pharmacies or Botox and some of the other type of

Aida Khanum MD (24:41)
Mm-hmm.

Steven Schwartz (24:59)
services along those lines. as you said, if you’ve seen one, you’ve seen one and that’s about as far as it goes. But everybody’s different. What’s neat about this is you have the flexibility of designing your practice the way that you want to do it. And if it works well, great. And if something doesn’t work as you want, you can always tweak a little bit, change a little bit and keep on going as entrepreneurs. That’s what we do. Little pivots, little tweaks here and there.

Aida Khanum MD (25:16)
That’s right.

Steven Schwartz (25:29)
to get us where we want to go and to get the best outcomes.

Aida Khanum MD (25:32)
That’s right. That is exactly right. There’s like five of us within a one and a half mile radius. And there’s one of us that does fourth trimester packages. That’s her thing. There’s another one that does just primary care. She doesn’t do any other extra services. And then there’s a third one that’s kind of incorporating multiple things together. And then there’s me.

I do primary care, but then I also do autism and ADHD. Those are the two extra things because I had done my fellowship, we had a little more intense training in that. So you’re right. It just depends. And I love the fact that you can do what you want to do. you do what you do you. And you want to work five days a week, you want to work six days, you want to come after hours, you don’t want to, you want to go to the house, you don’t want to. It’s totally up to you as long as you… I would say the way you grow is you are very clear about it at the front.

So that way people, because yes, the number one referral source is your current patient panel. And so if they’re happy with what you’re doing and you promised to fulfill your promise, they’re gonna go and share with their friends.

Steven Schwartz (26:40)
Love it. As we wrap up our interview today, if a physician is watching this and they want to speak with you personally to just chat, to get an idea more depth about your practice, a desire to create their own DPC practice, what’s the best way that someone can get in touch with you and schedule a chat?

Aida Khanum MD (27:05)
So yeah, so I have, so for my…

for consulting for transitioning and consulting. I’m going to be starting that and that’s going to be on my website and they can reach me via the email address on that. My email address is [email protected]. So I formally will be doing that will just really be for helping people who want to transition and it’s a four hour package that I give. But you know just for information you can always send me an email and my office number is 713-669-1900 my website

is www.pediatricpod.com and it actually is a pod. The reason I named it was because there’s no space. It’s just me and my patients and there’s nothing else in between. And so yeah, more information on that, but I’d love to chat and help. I really think this is a much needed change in our healthcare system. I think the physicians are great, but we would…

really hate to see the younger generation not want to do this because that’s what I’m hearing and seeing because they’re like, look at their parents. They’re like, no, after so many years and then you’re working so hard. And so really kind of encouraging the next generation that, you know, we still need good physicians. We need, and there’s a better way of doing it, which doesn’t cost you an arm and a leg and gives you better outcomes for both the patient and the physician.

Steven Schwartz (28:21)
Couldn’t have said it better myself. Wonderful. Thank you. One final thing I wanted to mention is that the marketing arm of my company, Concierge Medical Marketing, provides the different digital marketing services to help the Concierge DPC physician to succeed in their business utilizing digital marketing methods and strategies. And the way we’ve structured our offering

is based on one of three different programs. So the first is transition for physicians transitioning from a traditional insurance-based practice to a DPC. The second is growth. You have your practice. Everybody who’s transitioned maybe is already done. How do we grow? How do we get to 300? How do we get to 500? We have wonderful methods of helping achieve that for our clients. And then finally, nurture. You have several hundred families

that are your patients, it’s very important to stay in touch with them, with emails, with text messages, newsletters, maybe quarterly get togethers at the practice, and just helping people stay engaged with your practice. So we call that Nurture. So we’re able to help physicians with all three of these options. And as time and the practice changes, we can modify and pivot our plans as well to help the physician wherever they are.

I’ve written a book called The Definitive Guide to Winning with Digital Marketing for Concierge Medical Practices. And that book is available for free. Simply go to our website, conciergemd.marketing, scroll down the homepage until you see the book, put in your email address and click the go button. And our system will send you a link where you can download the PDF. Please read it with my compliments. And if you have any questions whatsoever, if you have anything you need clarified or want to chat with me, please.

Just reply to the email or give me a call, 772-304-2420. And it’d be my pleasure to speak with you and see if I can help you in any way. With that, Aida, thank you for your time today. It’s truly been a pleasure speaking with you. And I just encourage you to please keep up the great work with your practice, your families. And we appreciate you.

Aida Khanum MD (30:40)
Thank you, thank you. And I just wanted to say one thing. I totally agree, your marketing is key. Maybe I didn’t mention it earlier on, but a website where you can funnel all your patients to, to get them to learn a little bit about you on a very personal level, that website can make or break your practice. So for sure, I think what you’re doing is fantastic. And thank you so much for having me.

Steven Schwartz (31:03)
Truly my pleasure. Folks, we appreciate you being on the Concierge Medical Marketing Podcast and we continue to interview wonderful doctors and folks that are involved in this industry. Please subscribe and like and follow us wherever you are. And with that, we’ll call it a day. Have a great one and thanks for following.