My Thoughts on The Dip

Today, I finished reading "The Dip" by Seth Godin. In the book he talks about when to stick with a project and when to quit. I picked up this book for a few different reasons. First, it was recommended to me by a colleague in my small business community. Second, I felt instinctively that I was facing a decision point in my business, and I needed an external voice to validate what I've been feeling over the past few weeks.

"The Dip" is a relatively short book, and a key takeaway can be found in the section subtitled "Never Quit". Mr. Godin urges his readers to quit, which may be surprising at first. But his main point is this: "Never quit something with great long-term potential just because you can't deal with the stress of the moment". 

Starting a Direct Primary Care practice in Detroit has been one of the most difficult challenges that I've faced in my young career. With undergraduate study, MCAT preparation, medical school, and residency training, there is a great deal of certainty. The equation for success in these regimented environments is simple: study hard, get good grades, perform well on exams and you will succeed. There is a comfort in these structured environments, because I knew that if I studied for "x" amount of hours, I would earn "y" result.  

But with business and running a Direct Primary Care clinic, there is a great deal of uncertainty and a less direct relationship between effort and reward. For example, if I put too much effort into one marketing channel (Facebook or YouTube) and not enough into another marketing channel (email or in-person events), then I may not attract as many new clients. There is no specific formula for success. 

Even though there isn't as much of a direct relationship between effort and reward, I know that Direct Primary Care has excellent long-term potential. I truly believe that it delvers better health care at a lower cost, and that demand for this healthcare delivery model will grow, perhaps even exponentially as economic forces in the broader economy change.

That doesn't change the fact that there is a lot of stress in the current moment! The uncertainty about growth, next steps for the company, and broader adoption in the marketplace cause me a good deal of stress, and I was looking for something that spoke to these aspects of my business. Reading "The Dip" was like having an excellent pep-talk from a personal business coach. 

Intuitively, I can sense that I am in a dip, as described in the book by Seth Godin, and reading his book validated my feelings on my business at this point in time. It also gave some pragmatic wisdom with which I can rededicate myself to my business. After 6 months of operation, I can start to analyze what's working and what's not working. As Godin writes, "The opposite of quitting is an invigorated new strategy designed to break the problem apart". 

He goes on to describe a challenge I'm currently facing: acquiring more customers in the marketplace. He urges his readers to focus on the broader market rather than the individuals. I.e. don't call one lead 10 times, which he sums up nicely here in this passage, "If you try to influence one person, persistence has its limits". It's difficult to change the mind of an individual, and you want to avoid pestering people. 

But, the market is different than individual people. One line that struck me regarding this subject was his assertion that "most of the people in the market have never even heard of you". And this may be a good thing! He relates the story of Sergei Brin of Google and how it was better if customers found out about Google later on rather than right now. This gave Google more time to iterate and improve the product, which would then create better customer experience.

For now, I will continue to focus on improving my services and clinic flow, because I know that as each day passes, the experience of my customers improves. I will also be rededicating myself to email marketing, as I've let this slide over the past few weeks, so check your inbox!

Thanks for reading about the struggles of starting a Direct Primary Care practice. I'm looking to include some of these writings in a future project, so if some of the blog posts here seem random, know that they're adding up to something bigger in the future!

- Dr. Paul Thomas with Plum Health DPC