I get this question a lot when speaking to practitioners about starting their own micropractice, “Why would patients pay me?”

Do you wonder how someone would pay cash for your services? Do you think you need to offer fancy testing and really involved therapies in a high-end office space?

In my opinion, it is difficult to successfully run a medical practice dedicated to health promotion and take insurance. A direct-pay practice that lives outside of the squeeze and time crunch of insurance will have you loving work and enjoying your life. Many find this daunting, but realize the rewards, not all of them financial, are great. I find picking my kids up from school a couple days a week rewarding. I find three-day weekends rewarding as well.

Unfortunately, most think that in order to have a direct-pay practice, you have to offer expensive things. Not true. Offer you. Offer care. True care, the kind that listens to patients tell their story and doesn’t interrupt them. The kind of care that patients desire and deserve, but so rarely get. Want to know why my direct-pay, consultative practice has attracted 25 to 35 new patients every month for six years? Care. It’s as simple as that.

I used to hate my clinic schedule. I’d review it every morning and see all of the “trouble” patients who were going to take up my time and put me behind. Now, I look forward to seeing each patient, knowing I have time to hear them and connect with them. Those two things will likely provide more healing than any bottle will.

So, if starting a new practice or delivering care in a new way is intimidating because you think you need some special treatment or fancy machine, think again. Just be you.

As you design or refine your clinic, make sure to focus on delivering on these points:

  • Care– this should be natural. It’s why you do what you do.
  • Empathize and understand where your patients are coming from.
  • Feel free to say, “I don’t know, but I’ll find out.” Patients appreciate the honesty.
  • If patients are doing something that has no side effects and they think it is helping, be careful discrediting it.
  • Talk to your current patients about their health care experiences. Chances are, they are miserable. Ask them how they would change it and consider that in your business planning.

Here’s another pearl of advice as you plan this out: Don’t ask family or friends to advise you in your new venture! They have been getting medical advice and guidance from you for years for free and will say that they don’t think people will pay for your care.


About Jeffery Gladd, MD

Dr. Jeffrey Gladd graduated from Indiana University School of Medicine in 2001. He then went on to train in family medicine at Ball Memorial Hospital in Muncie, Indiana. After completing his residency, Gladd started a family practice that encompassed full spectrum care, including obstetrics, colonoscopy and endoscopy in Columbia City, Indiana In 2006. After the birth of his second child, Gladd transformed his professional and personal focus toward health through nutrition. By educating himself and applying the principles of eating whole foods, he lost 50 pounds, and reveled in improved energy and mental clarity. As a physician, increasing doses and adding medications was no longer acceptable. Gladd delved into his patients' lives — how they ate, how they managed stress, and discovered real health care.

Gladd completed the University of Arizona Integrative Medicine fellowship program under the direction of Dr. Andrew Weil, MD at the end of 2009. While in the fellowship, Gladd served as the medical director of the Parkview Center for Integrative Medicine in Fort Wayne, Indiana, and in 2010 opened GladdMD Integrative Medicine where he blends health-promoting care with high access technology.