In an industry where many work practices haven’t changed in multiple decades, healthcare providers often have even less work flexibility than their professional counterparts working in other industries. Pay gaps are prevalent and growing , and working parents struggle to find the time to care for their patients, their families, and themselves all at once, sometimes resulting in having to either scale back or leave the workforce.
Some healthcare providers are finding a solution to struggles of flexibility and work-life balance by escaping traditional brick-and-mortar care models and embracing non-traditional care delivery options made possible through technology.
Across specialties, providers are building new, technology-enabled businesses by integrating non-traditional care delivery models such as telehealth visits, house-calls, and digital health apps into their practices.
With these new practice models, providers are finding improved work-life balance through scheduling flexibility and increased efficiency, while also providing more convenient and improved care to patients.
Nutrition and Wellness
“For nutritional care, continued connection between appointments and creating relationships over time are two keys to great patient outcomes,”explains Erica Jain, CEO and Co-founder of Healthie, an all-in-one practice management solution for nutrition and wellness professionals.
“Telehealth (and associated technology, like Healthie) enables providers to build better relationships with their clients and to focus more time on patient care and less time on back-office administration associated with running a business,” Jain adds.
“We have seen telehealth (inclusive of photo-based food logging, secure messaging, and video consultations) help nutrition and wellness clinicians find more flexibility and a better work life balance, while building businesses on their own terms, on their own schedules, and by crafting specialties and niches that they enjoy,” says Jain.
Sarah Skovran RDN LD, Registered Dietitian Nutritionist and Owner at Sarah Skovran Nutrition, is one nutrition entrepreneur building a non-traditional business model that combines telehealth services and in-person visits at clients’ homes, grocery stores, or restaurants. She also offers clients the option to connect with her in-between visits via an app that enables client food logging, feedback, and encouragement.
Skovran has seen clients greatly benefit from convenient services and increased support between visits. On the business and personal side, she has less financial risk from only renting a space once a week and not having to pay overhead for appointments conducted from home. She also saves time on travel and has increased her reach to see clients beyond her area. Skovran explains,
“Telehealth is great because I live in a rural area, in a rural state. Some people are interested in my specialties, but would have to drive for several hours to reach me. HIPAA compliant video conferencing platforms have made it possible to see these patients.”
Crystal C. Karges, MS, RDN, IBCLC is a Registered Dietician Nutritionist and Owner at Crystal Karges Nutrition and a mother of five who offers mothers and family-based services via telehealth and in-home care. Karges started with telehealth as a way to “create greater flexibility in how I structured my services, both for myself and for the clients I seek to serve,” she says.
By combining telehealth with in-home services, Karges has been able to expand her client reach, and provide greater value to her clients, since she can be more flexible around scheduling based on their needs. Karges explains,
“one of my main goals with patient care is to deliver the highest quality standard of care and access to the resources needed to reach their wellness goals. Fortunately, this can be done now beyond the confines of a traditional practice setting, through virtual, telehealth, and in-home support.”
Physical therapists, frustrated with the high-stress, zero-flexibility work environments of traditional care models, and are starting to look for opportunities beyond traditional clinic-based work.
“Physical therapists often feel stifled by the model of traditional patient care, especially when family, travel, or community commitments factor in”, explains Meredith Castin PT, DPT and Founder of The Non-Clinical PT and co-founder of NewGradPhysicalTherapy. Castin adds,
“Traditional schedules in physical therapy can be very limiting. It can be tough to make things work when you have to pick up children from school, stay home with them when they’re sick, care for aging parents, or simply be home for deliveries and home repairs.”
As the workplace culture shifts to one with increased work-life balance and work-from-home options, physical therapists want to have the same opportunities to step away from in-person care and experience more flexibility. Castin believes that,
“Telehealth and concierge models can provide this type of increased flexibility for both physical therapy providers and patients themselves.”
After practicing for 40 years, Damien Howell PT, DPT, OCS now offices his services via house calls and virtual physical therapy visits, and he says this non-traditional model has enabled him to find “the happiest work situation [he] has ever been in.”
For Howell, providing home based services also allows for greater patient impact and more personalized service than in other care situations:
“Many times I have been able to observe and better understand the barriers and limitations that the client is faced with. We are able to adapt the plan of care to assets and liabilities of the client.”
Dr. Karen Litzy, PT, DPT has also escaped the walls of a traditional physical therapy clinic, and has spent the last seven years offering her New York City clients “an outpatient orthopedic clinic that comes to their home or office.”
Litzy’s clients, both individuals and businesses, appreciate the convenient care delivery option that better fits into their busy schedules. Litzy believes that she is having greater impact through her house-call model, because she “able to get a real glimpse into how [clients] live and work so [her] treatments and home exercise programs can really be tailored to their lifestyle,” and patients are more compliant because of it.
For Litzy, building a business around convenience for clients, has had a huge impact on her life as well. She is cash-based (meaning she does not take insurance), saving her time and allowing her to focus on providing the best care for her clients. Litzy has also found flexibility:
“I have the flexibility to create my own schedule which allows me to explore other side projects that can help me to grow and scale my brand and business.”
These side projects include hosting a widely popular podcast, Healthy Wealthy & Smart, creating The Women in Physical Therapy Summit, and being featured in publications and podcasts such as Health Magazine and Entrepreneur On Fire.
Like nutrition and physical therapy, primary care physicians are adopting new treatment options and creating models around better patient care through concierge memberships, virtual visits, house calls, and remote patient monitoring.
Dr. Kendrick Johnson is one example of a provider who has opted to build a family medicine practice that works best for him and his clients through combining house calls and telehealth visits.
Offering virtual care has allowed Dr. Johnson to create more meaningful patient relationships. He explains, “When I take time to have a virtual visit with a patient, they know that my goal is to help them be well and not just collect another copay.” Dr. Johnson also suggests that by offering the convenience of virtual visits, patients are more likely to follow through with important health recommendations.
For his practice, Dr. Johnson says,
“offering mobile health and telehealth has improved my efficiency and work-life balance in multiple ways.”
He is able to be more efficient, while having a greater impact with patients. The best part of his work? Dr. Johnson explains,
“I spend more of my time doing the work that I love and less time checking boxes to meet the requirements for a regular office visit.”
With companies like talkspace, offering app and online-based mental health therapy, and the advent of HIPAA secure telehealth platforms built specifically to serve behavioral health providers, technology is furthering the adoption of new care delivery models within behavioral health. These advancements offer both patients and providers more flexibility and convenience.
Bianca L. Rodriguez, MA, Ed.M, LMFT, is a psychotherapist and early adopter of non-traditional care models. She has been offering psychotherapy services via video / telehealth and home visits for over a decade.
Rodriguez feels that she is greatly benefiting her patients by offering more flexible care options. She explains,
“In this day in age we are more and more mobile, so being able to offer continuity of care when clients are away from home is essential.”
Rodriguez can better support clients if they are traveling, relocate for work, or need care in the field. She also finds flexibility, herself, by having the option to do calls from the office or at home. An added benefit? Rodriguez believes that offering telehealth services helps her better attract and retain clients, helping her grow her practice.
There are clear benefits to offering non-traditional care services – flexibility, time saving, and improved patient care, among others. These benefits are even more clear for providers who are considering leaving patient care to dedicate more time to to their families and / or themselves.
Though many providers are flocking to new delivery models as a solution to burn out and work-life balance, there are still many who are fearful of the challenges they may face while starting and growing a business in such a complex industry.
Thankfully, there are services, technology solutions, and companies dedicated to helping providers succeed in providing non-traditional care services.
Here are some options and advice from providers who already took the plunge:
Start a Non-Traditional Private Practice or Side Hustle
For practitioners burnt out with traditional care delivery, look beyond the traditional brick-and-mortar set up and take advantage of the myriad of companies offering business services and easy-to-use technology solutions aimed at supporting non-traditional care models:
Practitioners can now find affordable help establishing legal entities, finding business insurance, managing and tracking business operations, growing a client base, and building a brand, all while avoiding the risk of costly overhead that comes from opening a brick-and-mortar location.
Of course there are also challenges with building a non-traditional practice, so providers will have to weigh to pros and cons of both traditional and non-traditional options.
Join an Established Company
If starting a practice seems too daunting, or a provider simply wants less risk or responsibility, joining a company or a hospital system that is already providing innovative care delivery services could be the answer for them.
One such option is Virtual Physical Therapists, a company that markets virtual care sessions directly to patients. Aideen Turner, CEO, explains that providing care through Virtual Physical Therapists “has improved clinicians work-life balance, especially for our young mothers, who can now work a few hours at a time around their children school and sleep schedules.”
Neil A. Solomon, MD, FACP, Chief Medical Officer of MedZed, similarly talks about the flexibility and improved patient care ability that clinicians experience by working with MedZed. He says, “MedZed’s model makes clinicians more efficient and happier. One doctor currently looking to practice with us told me that MedZed will be giving him back three hours a day that is currently consumed on LA freeways.”
Additional companies like Maven, Physera, Parsley Health, AmWell, Doctor On Demand, Heal, and even hospital systems, like Vanderbilt Health System offer practitioners non-traditional care delivery options.
Tips from Non-traditional Care Practitioners
On Starting Non-Traditional Care Delivery…
My encouragement for other clinicians looking to start is to not be afraid to take that first step! The truth is that more people are searching for more flexible and efficient health care options, beyond what is provided in our current healthcare system. – Crystal C. Karges, MS, RDN, IBCLC
There are startups creating digital health treatments similar to Virta, and I would strongly recommend that my peers consider joining the clinical teams of these companies. Why? On top of providing a level of care that I was never able to do in person, I have gotten the chance to work directly with the engineers and designers that are creating the platform I use day to day. – Jeff Stanley, MD, Clinical Team Member at Virta Health
On Managing a Business by Using Technology and Support Tools….
If you are planning to offer video/Telehealth or see clients in the field, I recommend that you discuss the risks and benefits with you client beforehand, document the discussion and ensure your client has given you informed consent. – Bianca L. Rodriguez, MA, Ed.M, LMFT
Keep a notebook in your car to track mileage (if you are doing house visits), and confer with your accountant about the extent to which the associated expenses would be deductible. Make sure you have clear cancellation and no-show policies. – Sarah Skovran RDN LD
For telehealth, think about how you will accept payment. If you plan to do a lot of telehealth, there are platforms designed to handle clients paying by cash, check, or card, with many services integrated. – Sarah Skovran RDN LD
On Protecting Yourself and Your Business…
If you’re going to meet a client’s home, it’s smart to make sure someone knows where you are. Privacy issues might come into play here, so this is something to discuss with your attorney. – Sarah Skovran RDN LD
There are so many different tools and resources available for clinicians, just be sure that your systems maintain client confidentiality through HIPPA requirements. It’s also important to double check with your board about compliancy standards for practicing outside your state. – Crystal C. Karges, MS, RDN, IBCLC
As patients demand convenient, efficient, and cost-effective care, and payors and hospital systems are racing to find opportunities to move services to less expensive settings, the question becomes will these new types of care delivery models become the further of healthcare?
Healthcare, as an industry, is generally slower to change, in part due to its complex nature stemming from the separation of those who pay for services and the patients who are receiving them. Individually, patients are sometimes more reluctant to try out new ways of receiving care, finding more comfort in old models, even if those models equate to less convenience and inferior outcomes.
As such, scaling new models like telehealth, technology-enabled house calls, and digital health apps, required both a system wide shift and a build up of trust and comfort by individual patients.
Many experts, agree that, despite these challenges, change will continue and innovative care-delivery models will become more common place.
“I anticipate that the healthcare delivery landscape will change immensely in the next five years. Telemedicine will continue to grow, and many professions will leverage it to improve communication between patients and providers,” says Castin.
“I also predict an increase in remote consultations, which will allow clinicians with specializations to provide services to a wider swath of patients,” Castin explains.
Jain also agrees that,
“There will continue to be a movement towards client-centric care.”
“Consumers receive health information in the media, on their phones, through friends and family, and not simply in a doctor’s office or hospital – therefore healthcare providers will inherently need to be a part of this delivery on the go, a trend that technology-enabled delivery models support.”
Thankfully for healthcare providers struggling to find work-life balance in traditional care settings, a continued trend towards convenience and flexibility for patients, offers providers new options and changing workplace dynamics. By empowering providers with new solutions and options for flexibility, the industry can make strides towards lessening the pay gap and alleviating some struggles that many providers, male and female, currently face.