Wed, 28 December 2022
We've been getting a lot of questions on whether or not 2023 will be a good year to open a practice. The answer is, as it often is, it depends. In this episode, Scott McDonald goes through what signs to look for in a particular area to know if it is good time or not for that location.
Wed, 7 December 2022
I have not been publishing episodes on where to put a practice lately. But in my research, I have found two states that I have not discussed for a while that might be very promising given their favorable demographic character and extreme growth. If someone was to ask me what are the two places in the U.S. that are emerging as places with low risk and high potential, I would mention Nevada (south and northwest) and Arizona (Pima and Maricopa Counties) as two of the best. Oddly, even though the metropolitan areas are in the middle of extreme isolation (and desert), their rate of growth is truly amazing. They are not perfect (what places are?) but we cannot ignore them. In just a few years we will be talking about how many NEW practices have grown in this area and so many "experts" missed it.
I have visited all of these metropolitan areas in the last few years and by my own estimates, this represents the "low-hanging fruit in the Western United States." I just wanted to share that with all of you.
Tue, 29 November 2022
I had a little BrainStorm Session with my Demographic Colleagues about the Mid-Term Election. Most of us came to the same General Observations. One of the big takeaways is that experts should really be cautious about claiming to know a great deal about the future of demographics in the U.S., we just don't have all the answers we thought we had. That does not sound hopeful, but it is true.
These very smart people noted that there were certain trends in current demographics that they would like to ignore. That is what this session is about. The decline in the birthrate is especially important in our discussions. It seems strange that the mainstream media is ignoring the recent changes in the job market. The housing market, especially in the single-family, owner-occupied sector is largely ignored in the national media. We assume this is due to the fact that these reporters are not living in these communities. They are not concerned with consumer debt because they are affluent. Most reporters who own homes are on a fixed-rate mortgage. In fact, the important news stories touch them hardly at all.
This episode is an acknowledgment that there are some important trends and news stories that you hear little about that are not on the elites' radar screen but will be quite important to doctors who want to establish practices.
Wed, 16 November 2022
This episode has so much detail, we do not have a "Short Version." I had to be complete.
I define the differences between these types of sites. In a nutshell, it is important to make the distinction early on that it is more than population size and growth rate. The rural sites are not necessarily more or less desirable. The biggest difference is in population density. Rural sites are more spread out. They have more homogeneity in their lifestyles, In each practice-community area, there are different liabilities and benefits. I mention these in the narration. Demographers are generally cool (at least for now) on urban locations. They are losing population in the post-Covid world as costs, including taxes and other business expenses rise. Suburban locations seem to be the least attractive for reasons I will discuss in the episodes.
I am not saying all practices have to locate in certain neighborhoods. It is certainly true that suburbs carry far less risk. Rural practice sites seem to be struggling to get a sufficient patient base, especially with the rising costs of fuel. So we have here a balance between ideal practice locations, their benefits, and liabilities. This episode contrasts all of these.
Wed, 9 November 2022
These episodes represent a word of caution regarding your source of demographic information on data and analysis. There are lots of amateur demographers who have entered the field recently. True, they may be well-meaning. These "newbies" are usually getting rehashed" data from a source within the Federal or State bureaucracy]that purports to tell you about changes in demographics. It isn't necessarily true that the data is wrong. The biggest danger to doctors, consultants, and brokers is that they often make claims about the viability, and risks of practice site analysis.
I refer to them as "amateurs" because the analysis must be based on their knowledge of the professions they are measuring. For example, one must know if the distribution of providers in a suburban area is at, above, or below the norms for that type of practice being considered. Urgent Care practices have different thresholds of success than dental practice, for example. A practice that relies upon internal versus network referrals has different measurements of success.
In short, knowing how demographics relate to the profession you are undertaking is not simple and requires experience with the population AND the measurements that will matter.
Beware trusting demographers who are new, inexperienced, or generalists. You cannot afford this kind of mistake.
Wed, 2 November 2022
As spaces for ideal practices become more difficult to locate (not to mention more crowded and expensive) finding a place that will serve all patient-bases is a growing challenge. Rather than locate the perfect place, doctors are encouraged to create practices that will meet the needs of more "specialized and specific" market segments. Thus, it makes sense to consider a "niche" practice."
It is not so much that the doctors have to find an "edgy" approach to medicine and dentistry. They only need to find a patient population that is large enough and identifiable to pay the bills. In this episode, we consider market segments such as culture, language, nation of origin, demographics (age, education, income for example) or psychographics (lifestyle and "values") that would not necessarily be one the radar screen of all practices. As an example, Armenians, different religions, political or professional groups would work well. If the local population has these people in sufficient numbers, a niche could be identified and the practice can proceed to promote its services to them. Additionally media consumption (advertising) could be planned that would meet their needs exactly. Granted, not all clinical needs would have to vary. Still, they could be sifted to meet their needs and interests.
In the end, healthcare practice may be able to thrive by identifying the common interests of a very specific segment of the population rather than trying to be "all things to all people.
Wed, 12 October 2022
When examining the viability of a practice site, it is important to know how many competing providers (doctors) and practices there are. That much seems obvious. But we also have to acknowledge who the REAL competitors are within a practice area. In the case of healthcare, you should be aware that not all doctors/practices are true competitors. As an example, there is a significant difference in the range of procedures and equipment available among practices. A veterinarian may not treat and diagnose the same animals as another practice. Dermatologists may have the same training but they offer very different care to different patient types. Not all orthodontists are the same. In short, when contrasting doctors of similar disciplines, we are wise to judge that they may not be true competitors at all. Only a demographer with experience can recommend a site based on the variables in practice types. It is usually insufficient to make a broad conclusion about the competition unless the variations in practice and clinical care are understood.
At Doctor Demographics, we recognize that sometimes general practices are significantly different in who they target for treatment and the niche they occupy. It is foolish to assume that all practices will offer the same services to their patients, even if they SEEM to be alike.
So, if you are trying to determine if there is "room for one more," it is vital to have a demographics firm that understands healthcare do your research.
Tue, 23 August 2022
Several Clients have mentioned that Southern California is not looking so good as the place to purchase or to start-up a practice. Back "in the day," growth (and glamour) seemed eternal in the five mega-counties found in the area (Orange, San Diego, Riverside, San Bernardino, and Los Angeles Counties). For the first time EVER, the area is losing population. Among demographers, this has been known as the "California Exodus." True, the birth rate has declined (it has lost at least one Congressional Seat) but there are some other things going on. This episode defines some of the trends. The Governor and the State Legislature are agreeing to raise taxes, restrict water distribution, and the raise the prices on land development.
This episode takes about where these trends are occurring and where they are NOT occurring. We also discuss other trends that are important to keep an eye on. This would include an idea of where the middle class has gone. For doctors who want and idea of what is going on (and WHERE it is going on), this can be an important episode.
Tue, 9 August 2022
We have been asked about the viability of New York City as a place to practice for a long time. We thought this might be a good time to clear the air and make a definitive statement on it right now. As the nation's largest city, it is certainly a viable option. Still, the City is losing (a little) a population of -0.3 % per year.
From the standpoint of a very large and dynamic community, that is not bad. There are also indications that many of the people who left are going to come back.
But there is a severe bit of caution that goes along with this. The returning population is older and much less "family-friendly" than before. The large numbers of Young Adults are not as likely to come back. From an employment perspective, this might work out. Recall that those who left NYC for New Jersey and Florida still love the Big Apple but are not "starting out" as they did before.
This MAY turn out to be a big problem in the future. Crime and a housing shortage are certainly not helping. But, on the other hand, the rules that have defined other urban areas are not as true in this area. That has made many demographers more hopeful about NYC's future. Still, the nature of the City is unique.
As I have written before, NYC is more of a collection of small cities and villages crammed in an urban setting.
To KNOW the opportunities and risks of such an evolving and diverse community requires special help. Doctor Demographics is there for you, no matter what type of practice you are considering.
Tue, 2 August 2022
This is the second episode of the Politics and Demographics podcast.
Last week, we discussed the implications of how the Mid-Term Elections are going to affect doctors. Our theme was on the House of Representatives (Congress) and some of the changes that are likely to occur. This week we will consider what will likely change with a turnover, even by a single seat, in a 50-50 Senate. Polling has shown that Americans (mostly young Americans) are going to be surprised and even alarmed with the likely changes that will occur. We do not live in a Democracy and very few are aware of how a Republic works. This is a solid primer on what people need to know.
I am a little worried about the surprise and perceptions that will come in America regardless of who wins. There are a fixed number of Senators. It is their relative party affiliations that are going to the cause of all the heart-burn.
This is information you need to know.
Mon, 25 July 2022
In this episode, I discuss the specific aspects of demographics that are causing all the craziness. And it is worth considering in some detail how folks seem to want to look at politics as a "blood sport." No, I don't discuss much the morality of choosing one side or another. Assigning blame is unwise. But it is true that if you are going to choose an area to purchase or start a practice, some places are going to look much better than others. Hey, that is my job. Right?
Mon, 18 July 2022
In this episode, we have taken a deep dive into two concepts that will determine your future practice success or failure. Please understand: They are not mutually exclusive. Rather, they are factors of potential that doctors must understand.
Many people (including doctors and practice owners) do not grasp. Even our competitors are a little foggy about their meaning. The first is the difference and relationship between race and ethnicity. The viability of practice often (increasingly) depends on a thorough understanding of the differences. Last week, we discussed "Hispanic" countries and populations. This week we are examining their culture, nation of origin, and language. We have expanded the discussion to include other countries. But we want you to see how this can influence the potential of this information in your practice.
The other concept (which heavily predicts success or failure) is demographics and psychographics. Both are vital to understanding the risks and rewards of a particular site on your potential business success. They are not the same thing at all. In the end, they are the key to promoting your practices and managing any new growth you may have.
Still, this is only a start.
We are also announcing that in September, we are going to offer a webinar on the best places to practice ortho, oms, emergency care, and endo in the United States. Stay tuned!
Tue, 12 July 2022
I only wish there was sufficient time to discuss all I have learned about the Hispanic population in a single episode. Nevertheless, I have created a long and short offering about Hispanics that will provide a little insight into these important groups of people. Not a day goes by that we don't hear about their immigration numbers. The Southern Border is being crossed into the United States by ever larger numbers and this may prove vital to your practice. Who are they? How do you reach them? Are they ALL desirable as a patient base? This episode is just a start to understanding the "Hispanic Switcheroo." And in this very short version of this episode, you will doubtless learn some important facts that you may not have heard before, I have often said that Hispanics are an important part of our national growth. Practices need this information. As an experienced Hispanic marketer, what I have to say might surprise you!
Tue, 28 June 2022
During the course of my work I read many articles and journals that apply to healthcare practice demographics. Much of the time, demographers form a consensus on the big picture. Often, these analysts and researchers can come to disagreements in their conclusions. You would expect nothing less. But to help our doctors, I have gleaned some factors that I think they should know to make wise decisions for their practices. This episode explains some of the take-aways that will help our practices.
Rather than illustrating these trends with data and algorithms to prove my point and recall studies that may conflict somewhat, I have put down trends I think you should know. To illustrate, demographers take a more "fatalistic conclusion" on our economy. We don't have to take into account whether this will help or hurt President Joe Biden. We (as demographers) call the balls and strike as we see them. Is the Birth Rate rising or falling? Will healthcare practices see a reduced labor force that could hurt doctors? Where is the housing market headed? That is the nature of our discussions.
The long version of this webinar will, at least, give you an idea of what trends are most applicable to doctors. After all, they are our key, target market. I think that much of what I discuss is obvious. You DO sense that many doctors are holding back their applications for school. Right? This is a trend (among others I discuss) that will help guide you in your decisions.
Tue, 21 June 2022
In the last couple of weeks, I have been asked by subscribers to the Podcast for the locations that are winning and losing population. Rather than break them down by states, I have looked at the Metropolitan Areas that the U.S. Census Bureau has identified as those that are likely to grow or shrink.
It sometimes surprises them to see how much greater the loss to a densely populated area is relative to its growth. To adequately describe the trends in population, we introduce the concept of "Dispersion." This is the process of making the process of going from a densely populated area to one of less density (not just population size or rate of growth). In the post-Covid world, it seems that everyone wants a little more space in which to live. Having neighbors may be necessary but we don't want them TOO close.
This episode describes where people are considering their destinations. If our purpose is to help you find viable sites, we need to tell you how they are getting better or worse.
I am not seeing more practices for sale. And finding places to start a practice from scratch is not so simple. This episode shares with you some real numbers.
Take a look even if you are going to put off your decision for a while.
Wed, 8 June 2022
Last week, we reviewed the "Places with the Kiss of Death."These are locations that I am strongly suggesting you NOT consider a start-up practice or a practice purchase. My reasoning is based upon the fact that their demographics are not looking particularly promising.
This week, we are looking at sites in the United States that are looking more hopeful. These locations are economically strong and show signs of growth. Many are manifesting strong economies or improved employment trends. Unfortunately, the short version of this episode can only lightly pass over the location. Still, I think it will stimulate your thinking.
Let's face it, the U.S. is looking at a period of economic risk and potential decline. Interest rates are surely going to rise. Still, that is no reason to sit on your hands while opportunities to grow are just over the horizon.
This episode explores the places where the potential for growth (and wealth) can be found. These are the places that still have risks but the risks are mitigated.
I hope you will allow Doctor Demographics to explore with you the places that have Promise!
Wed, 1 June 2022
Every year, we publish a list of the sites that are "Risky." We call these areas the "Kiss of Death" Sites. If you are considering one for purchase or a start-up, we want you to think twice. The factors that make these locations less-than-desirable, change each year. For example, in recent years, locations that had high unemployment were risky. But at this time, unemployment has not been a major factor in what makes a good or bad location. Rather, this year, locations that have above-average crime are undesirable. Perhaps more important, locations that have the high cost of living, rising taxes (income and property) and a reduced birth rate are having a more difficult time, Almost without exception, they are losing population.
In this episode, I take the time to examine the key factors that matter as well as the specific states and cities that suffer from "The Kiss of Death." Unfortunately, the list is long so the "Short Version" is inadequate to cover it all.
This is an important episode if you don't like risk. And I have tried to be as specific as possible just why this is so. Some locations (many) are committing economic suicide. Others have adopted a poisonous political message that is going to harm them. In the end, it is not a single factor. Rather, it is one of many.
I hope you enjoy this message and take it to heart
Wed, 18 May 2022
It has been true for a long time that brokers, realtors, and even demographers have considered only a very narrow number of factors in determining practice site viability. Traditionally, this may have been due to a misunderstanding of how to interpret the available data. We knew, for example, if the population surrounding a practice site was growing or shrinking. We certainly could tell if the competition around a location was increasing relative to the population. Terrific! But the science of demographic analysis has grown and deepened while the users of these numbers have not kept up. And there is little surprise why this is so: it is heavy lifting!
Wed, 11 May 2022
I believe (as many researchers do) that we are heading for an economic downturn soon. The only way to thrive during these times is to get the research and then make a plan and THEN you have to stick to it. That is what this episode is all about. But you need to make your plans soon!
Thu, 5 May 2022
What goes up will invariably come down. It is a basic law of gravity, economics, and demographics. We can simply not hope that things will stay the same (either good or bad). Frankly, we are at a time when it appears the World is sliding into a Recession. This has long been predicted. So, with this in mind, we have to assume that there is going to be a "wobble."
Wed, 27 April 2022
This episode discusses the ways that you can work with these local and national trends to build a new patient base that is educated and ready to work. We will discuss the priorities of these migrants, where they might settle, and what you can do to attract them to your practice. Please be aware that Doctor Demographics can identify where the new immigrant residents are moving, what they want from your practice, and how to attract them.
Tue, 12 April 2022
Go South Young Man! The national trend right now is to look at the southern end of the country for opening a new professional practice. There are many big cities that are growing there and there is tremendous attention from the doctor community. So, the big question is this: Should YOU Go South?
Wed, 6 April 2022
Doctors often find themselves influenced by locations that OTHER doctors are considering for purchase or development. This session explains how this is both good and bad. It also features the parts of the U.S. that are good bets and those that are not. For more information, visit us at: https://doctordemographics.com
Tue, 8 March 2022
Tue, 1 March 2022
Tue, 22 February 2022
Finding a location is tough. But there are non-demographic factors that can offer you a serious hint about places that show potential for practice locations or may serve as a warning NOT to go there. This session is about how retail sales is a sign of the good or back potential for practice.
Tue, 15 February 2022
It has long been popular to place practice in a "Medical Plaza" for various healthcare offices. There was a sense of unity and protection for these practices. This podcast deals with the issues that you might keep in mind. But the rationale for these centers is shifting. This video is a must-see!
Direct download: Plaza.mp3
Category: -- posted at: 11:41am EST
Tue, 8 February 2022
In order to do proper practice viability or best sites report, knowing a practice's borders and boundaries is all-important in order to offer geographic "context" for the site, Yes, we will discuss isochrones, proxemics, and centers of gravity. This is very useful stuff!
Wed, 26 January 2022
In this episode, Scott Mcdonald dives into why you should put a practice where the perfect place is as well as the three traditional demographic imperatives for practice: economic growth, population growth, and socioeconomics.
He said, "A rising birth rate is one indicator of who can step into your practice and benefit from it." And remember, the percentage of people tends to be even more important than how much they're earning. Also, when it comes to choosing a location that shows the most economic potential, you will have to move in because of job opportunities. Thus, moving target is going to determine so much of your success.
Direct download: Makes_A_Perfect_Place_to_Practice.mp3
Category: -- posted at: 3:06pm EST