Competitive Strategy Design of New Special Clinics Entering Primary Medical Market under Health Insurance Regulations: A Pain Clinic Case Study

Throughout human civilization, there have been endless social expectations for advanced medical technology and better medical quality. For primary care clinicians, it has been their responsibility but also challenging getting these brave new medical therapies into their daily practice; and that requires professional managerial knowledge and technique to make this process efficient, cost-effective, and continuously profitable. Taking pain medicine for example, the “niche-based special clinics cluster (NBSCC)”model may be the best service channel to introduce these new therapies under the regulations of National Health Insurance (NHI) here in Taiwan.

Under the landscape of vigorous competitions from various levels of medical entities and the rigid regulations from NHI, however, the newly-developed clinics have to build up innovative business models and competitive strategies in order to successfully enter the primary care market. Taking the pain medical care as the niche, we propose the following major competitive strategies :1. set the physician him- or herself as the core treatment provider (rather than the medical team)；2. utilize niche-based, low-risk, high-profit non-pharmacological pain interventions, such as high-resolution ultrasonography (HRUS), dry needle myofascial release, dextrose prolotherapy, intra-articular hyaluronate injections, and bio-identical pain medications；3. add-on pricing policy, including NHI-covered payment for clinic entry with self-paid fee for the above-mentioned medical interventions；4. enhance quality of medical care via one-stop “diagnosis-then-treat” mode, increasing average patient visit span, and in the same time reduce the potential loss from the NHI cascaded reimbursement；5. minimize the clinic size, both for optimal operational management and future clinic duplications；6. build up a blog-based pain medical information platform as one of the knowledge-accessing portals for the patients. These strategies can effectively and clearly separate out a distinct segment in the primary care markets, therefore further attract our targeted customers such as the middle-class and beyond. Through the successful setting and running of the first northeastern Taiwan pain clinic which put these strategies into practice, our proposed model was initially proved and verified.

Heading for the future, the advanced development of the special pain clinic cluster should focus on its core competitive advantage, namely the innovative and friendly pain diagnoses as well as treatments. Rather than traditional chain-clinic management, our research adopts the “swan geese flying theory”, which include the following key components: 1. taking the professional medical knowledge of the participating physicians as the core content of management；2. the knowledge management team of the cluster dose not actually own or run the participant clinics；3. member-paid web delivery mechanism of integrated new medical educational information；4. certification programs to gate the care quality of the member physicians；5. The leader of the clinic cluster plays the role of chief knowledge officer (CKO), taking lead in directing the geese (participant clinics) flying to the goal of “green medicine”, and allocating business profits towards the knowledge management team.

Overall, the analyses, design, and verifications of this research can provide helpful insights for future medical entrepreneurs or investors as they intend to step into primary care markets.