‘The future for private practices is going to be fintech first:’ How one startup is trying to keep clinicians independent

What would it take to get doctors, therapists and other healthcare professionals to stay in private practice?

Many believe that that ship has already sailed; last year, for the first time, the American Medical Association found that less than half of doctors worked in a physician-owned medical practice – the continuation of a trend that’s been evident for years now.

Other healthcare professionals – like psychotherapists and dentists – have been similarly feeling pressure to join large employers.?

The reasons cited generally come down to scale, money and flexibility: as insurers and hospitals consolidate, being part of a larger entity gives you more clout. Larger employers also can provide more layers of coverage. Not to mention – at least in theory – clinicians can spend more of their time on patient care, and less on the headaches of running a business, including ever-changing technology requirements.

And with non-traditional players like Big Tech and retail pharmacies joining the rush to employ doctors and psychotherapists, employment opportunities abound.

But I recently spoke to a startup founder who’s betting that the trend toward consolidation may actually start to reverse course. What’s standing in the way of clinician independence, argues Mario Amaro, MD , CEO of Ease , is not having access to capital. Ease (formerly DocSpace) aims to help healthcare professionals set up a practice as easily as small business owners can set up a storefront on Shopify.

Some of the trends he sees converging are:

• a move to more direct-care or concierge practice models,?
• a digital-first approach to healthcare where clinicians no longer need to invest in costly brick and mortar offices, and
• doctors feeling like their autonomy and authority are being taken away from them (something I recently covered when Amazon offered $3.9 billion to buy primary care provider One Medical).

You can read my conversation with Amaro below.?

And tell me: What do you think of the model of launching a practice virtual-first? And what shifts, if any, would make doctors, therapists and other healthcare providers return to private practice??

The transcript below was lightly edited for length and clarity.

LinkedIn News: Why did you decide to start Ease?

Amaro: Clinicians aren't taught the business of healthcare. We aren't taught the business of private practice. If you want to think about why me individually, I didn't grow up with healthcare ; I didn't grow up with a family with money. I had to leave my community in order to access healthcare. So this is a bigger problem for me. I'm trying to get clinicians that look like me, that speak the language I speak, that come from communities like mine, to go back to their communities, to practice healthcare and to provide that direct access. Then also I know burnout exists. I know a lot of clinicians start to get completely destroyed by the healthcare system. And so rather than have them leave, how can we figure out how to get them to stay in a different way where they believe they have more autonomy?

LinkedIn News: What have you seen that made you think that Ease could be a viable business?

Amaro: Being a physician myself, I have a lot of colleagues that are in healthcare, not just medicine itself. Millennials and younger people want to start businesses – it’s the same creator economy concept. People think that just because we're in healthcare, we don't want that – yes, we do! The problem is that there's really no infrastructure, there's no technology that exists, because for the past 20 years, modern technology hasn't been built to support small business; it’s been built to support employers, those enterprise-level models.

LinkedIn News: Can you give me a sense of your scale or any sense that this message is resonating?

Amaro: Early on, when we first announced this, we had over 1,000 clinicians on our waitlist – when I say clinicians, that’s optometrists, dentists, physicians, therapists, everyone, because this is a problem that exists for so many different people who are licensed professionals. One thing that surprised me when we got started is that we had doulas reaching out, we had occupational therapists, people who weren’t even on our radar.

But we're a startup; we had to focus. So we decided to go to market with psychotherapists first. And it's been incredible. We just launched 50 new therapists [on Aug. 10], meaning their practices went live and they're seeing patients. In total, we've built over 100 practices 100% from the ground up and so this is something that people really, really do want. It's a matter of how do you do it in a way that's scalable, a way that they're providing true value, one where they're actually growing. Then it actually makes a huge impact for them individually and also for the communities in which they're going to be practicing.

LinkedIn: What about the ROI of being in private practice versus an employment model? For example, you mentioned therapists. There's a lot of demand for therapists, including from Big Tech and telehealth companies.

Amaro: Most people do choose employment because of that paycheck security. But then again, what happens when you eliminate the financial barriers of getting into a practice? Traditionally, you think about a practice as brick and mortar, right? Our concept is: why does that have to be brick and mortar first? Why can't it be virtual first??

That's what we're thinking about differently. We're thinking about what businesses could you start virtually or even potentially in a coworking, shared environment. After you validate your business, you have enough patients, you have growing revenue, then you can make that decision to say I'm going to get into brick and mortar and take on that additional expense to continue to grow and expand my practice or my business.?

LinkedIn News: Let’s talk about what Ease does.

Amaro: We are very much building what Shopify has done for e-commerce. We're doing it for healthcare; it's a regulated space, and Shopify, because it was built for e-commerce, doesn't fit the regulations that are required in order to get a healthcare business off the ground. And the other problem is they don't integrate with any of the digital health tools you need to operate that practice.?

Our infrastructure includes things like your marketing website, the tools you need to see your patients, a calendar, payments – all this stuff for free. The only thing we charge for is incorporation. We as a fintech company are making our money off of banking, you know, interchange, things like that. We give you access to capital to be able to start up, we give access to loans to be able to grow. We believe the future for private practices is going to be fintech first.

LinkedIn News: Do you offer any help with how to run a business?

Amaro: That's actually how we went to market. First off, starting a business is very risky. We also know that there is that fear of failure, especially for clinicians. And one thing that eliminates some of that fear is training.?

We launched a six-week fellowship course where 50 therapists came together to start their practices, 100% from the ground up. We gave them mentorship. We gave them access to materials like how to market your practice, how to incorporate, how to think about banking, and so on. We combined it into a six-week course and launched our first 50 in March and our second 50 [this month].

LinkedIn News: What’s next for you?

Starting this year, we're diving back into medicine. We're doing a small fellowship for physicians, primarily cash pay, direct primary care. And then next year we will start working with those who want to be in value-based care. The whole purpose behind our model is to allow clinicians to operate tech-enabled practices because we haven't seen the world where private practices are completely built from the ground up, as tech-enabled businesses. That's the really exciting piece here.