Competition from Mid-Level Providers

What exactly does that mean? Simply put, competition is described as two or more entities competing for the same pool of patients/clients to gain an advantage over the others. This type of competition or gain is usually over market share in the industry. In our industry, competition may be between physician owned medical practices and external medspas owned and/or operated by non-physicians with an external medical director in order to remain compliant in states where nurse practitioners cannot operate independently. 

The term mid-level provider may be insulting to non-physician providers. Wikipedia defines mid-level practitioners as healthcare providers who have a defined scope of practice. The term mid-level refers to the complexity of healthcare situations they handle, not the quality of the care provided. The term is not meant to be insulting, but rather a differentiation between the physician and non-physician provider. 

When medspas became popular, many corporate America entities opened up corner stores in a strip mall or shopping center providing aesthetic and cosmetic services to patients who had previously gone to physician’s offices to receive these services. Many times, the mid-level provider performed the treatments under the direction of the physician or medical director. 

So why is there such an outcry of mid-level providers competing in the industry? The main reason is because the manufacturers of the products such as dermal fillers and neuromodulators actually have professional trainers who are not physicians, but rather mid-level providers and these same providers are as professional and experienced as the physicians themselves. These mid-level providers have become direct competitors to physician owned medical practices and often charge a much lower fee for their services due to much lower overhead costs such as rent, staffing, utilities, electronic medical record (EMR) and websites. 

Lower fees have been a major driving force for newer patients who just want to shop for their services, and the cost makes all the difference in the world. In order to gain an advantage, many mid-level providers have turned to Groupon and other shopper discounts to attract patients which increases market share by taking long term patients away from their usual provider.  

Experienced mid-level providers have become just as, if not more experienced at providing these services and are here to stay. 

So how do we equal the level playing field. The key is not marketing or advertising yourself as board certified any longer. That worked years ago but the general public has accepted mid-level providers as equals which is why the market share has shifted so drastically. A strong social media presence, a high converting and optimized website, authentic patient reviews and community relations have now become the key factor in attracting and converting patients, so your game needs to be stepped up if you want to compete with everyone else. 

This does not pertain to actual surgical services where I strongly promote the providers to be board certified specialists in their field of expertise. 

About the Author 

Jay A. Shorr, BA, MBM-C is the CEO and Founder of Shorr Solutions, a national and award-winning consulting firm assisting aesthetic practices with their operational, administrative and financial health. He served as the vice president of operations and practice administrator for a leading board-certified dermatologist and cosmetic surgeon in South Fla. and has previously held partnerships in two leading South Fla. plastic surgery centers. A veteran in the conference lecture circuit, Jay serves as an adjunct faculty member at Florida Atlantic University teaching a medical business management course. He can be reached at jayshorr@shorrsolutions.com