1. 1
Crossing the Direct Care Chasm
Tom Kippola
Co-founder & Managing Director, The Chasm Group
Hint Summit
April 28, 2017

2. 2
The Number Of Direct Primary Care Practices Is Growing Fast,
But Where Will The Growth Go From Here?
273
621
May ’16 April ‘17
Source: DPC Frontier, 4-24-2017
A
C
B
D

3. 3
Significant Threat To The Growth Of DPC:
Doctor’s Fear Of Adopting The DPC Model Is Too High!
DPC doctors on why their doctor friends won’t switch To DPC:
• “ ‘I’m scared’ are the first words out of their mouth”
• “The number one reason people don’t do it is because they are afraid”
• “People worry they are not going to make it”

4. 4
Q: What Was Your Anxiety Level In The
Weeks Before Your Decision To Switch?
What 3 DPC doctors in this room said to me:
• “The anxiety that I might fail was a 7 out of 10”
• “My anxiety was a 7-8 out of 10 that I might fail”
• “The personal stress was 9 out of 10. The financial stress was a 7 out of 10”

5. 5
Most Humans Weight Losses Far More Than Gains
Gains
1X
Losses
~3X

6. 6
Innovators Early
Adopters
Early Majority,
Pragmatists
Late Majority,
Conservatives
Laggards
Try It!
Stick with the Herd! Move Only
when Necessary!
No Way!Move Ahead of the Herd!
The Innovation Adoption Lifecycle

7. 7
Discovering the Chasm
• Early market largely done adopting
• Mainstream adopters not ready to adopt yet for 2 key reasons…
Early Market Mainstream Market
Chasm

8. 8
Reason #1: Mainstream Adopters Want
Mainstream References
But, this how 3 DPC doctors in this room describe their switch:
• “This is very much a leap of faith”
• “Researched for a year and a half and decided to make the leap”
• “Considered the move for 3 years before making the leap”

9. 9
Crossing the Chasm
• Chasm Crossing Problem
– Typically around chasm, only “80% solutions” are available
– But, Mainstream adopters won't buy “80% solutions”
• Solution
– Accelerate formation of a repeatable whole solution to create
reassurance for mainstream buyers
– Repeatable whole solutions often created via alliances

10. 10
Reason #2: Mainstream Adopters Want
Evidence Of A Repeatable Whole Solution
However, this is what 3 DPC doctors in this room said to me:
• “I winged it”
• “I overdid it with consultants…I used a lot of consultants”
• “I spoke with 30 DPC & concierge docs over 3 years before
making the leap”

11. 11
Draft Key Ingredients of A Whole DPC Solution
Intended as a starting point for discussion & iteration
• From software vendors:
• Direct care administration platform
• EMR platform
• Patient communication platform
• From services vendors:
• DPC best practices from consulting firm specializing in DPC
• DPC practice financing solution from bank specializing in DPC
• DPC legal agreements from law firm specializing in DPC
• Best practices educational content: videos, books, papers, seminars, etc.
To reassure mainstream adopters, alliance vendors
need to agree to the key ingredients &
refer to them in prospect communications

12. 12
Crossing The Direct Care Chasm --
Summary Recommendations For Consideration
1. Form a strong alliance of key DPC software & service vendors to accelerate
the creation of a repeatable whole solution…ultimately to reassure early
mainstream adopters that they can trust the solution.
2. Mainstream adopters who succeed with this repeatable whole solution will tell
other mainstream adopters that it is safe for them to adopt now.
3. The messaging of DPC Industry players will need to evolve from celebrating
only early adopters to increasingly also celebrating mainstream adopters.