Building A Home Based Concierge Practice

The writing was on the wall.  I was spending hours upon hours filling out paperwork.  When you support 2500 patients, the faxes and check boxes seem endless.  I felt like I was rushing through patient encounters to get back to my desk to handle the ever building stack of to-dos.  And the office practice was a wash.  Between supporting two offices, 15 employees, and all the infrastructure, I was barely making a dime.  Most of my salary was coming from my morning and afternoon visits to the nursing home.  This was the initial impetus for building a home based concierge practice.

Nursing home patients were needy and in abundance.  Furthermore, my work there required almost no overhead.  I had a ready group of patients available at my beck and call.  I didn’t have to pay for the nursing staff, electricity, or WiFi.

It was the perfect setup for a low-cost, high revenue practice.

Not Ready To Let Go

But I was not ready to let go of outpatient care.  I loved seeing patients in the office, and enjoyed the relationships I had built over years.  Yet the stress of taking care of 2500 people, and all the incumbent cost and  paperwork were becoming prohibitive to living life.

Like a flash of lightning, the answer came to me.  I wrote a letter to all my existing patients.  For a specified amount of money a year (for services not covered by Medicare or insurance) I would visit them in their homes. Given that I could fully support myself with nursing home work, I had few expectations.

If as little as ten people bought into the idea, I would be just fine.

Why?

Because with no office and almost no employees, my overhead would be next to nothing.  All I needed was a car, a computer, and a few supplies to carry with me.

My home based concierge practice was ready to go.

A New Adventure Begins

Roughly a hundred patients followed me into my new practice.  While this doesn’t sound like a lot, I could afford just about any number.  My nursing home business was steady, and my overhead was quickly approaching zero.

I hired a lawyer to help me structure the practice, and bill appropriately as to not run afoul of any Medicare regulations. I hired an accountant to organize my finances.  And I hired a personal assistant to run my practice.

All billing and paperwork were done electronically, and most were manageable over a mobile connection.

I visited my patients in their homes, the hospital, and nursing facilities.

Building a home based concierge practice was oddly easy.  I had removed all the complications and headaches associated with a large office and multiple employees.  Anything that was at all painful (like billing) I outsourced.

Content and Discontent

I really enjoyed my home based concierge practice.  I reduced the amount of paperwork ten fold.  My business overhead was strikingly low.  Most of the money earned went directly into my pocket.  My patients paid their annual fee on January 1st so I was usually flush with cash.

This was by far the best economic and quality of life arrangement I had ever set up for myself.

Until I was done.  After years of saving and earning prodigiously, I realized that I was financially independent.  I looked at my current practice situation with an eye on cutting back.

The home based concierge practice was the first on the chopping block.  It was the most unpredictable part of my daily schedule, and the cause of the greatest amount of stress.

So I closed doors on the practice at the beginning of this year.

The first of many steps towards downsizing to early retirement.