DDx — DERMATOLOGY GROUPS
Dermatology: the five ways this presents
Each presentation below lists what could be causing it, ranked, with the finding that tells the causes apart and what resolution actually looks like. 25 causes, 25 tests, each cited to a primary source for this specialty rather than borrowed from another one.
Nothing on these pages describes a client or an engagement.
PRESENTATIONS
-
Patient acquisition cost is climbing
[COS] "We're spending more per booked consult every quarter and the consults are worse." Media budget up, inquiry volume roughly the same, the injector's column no fuller. [MED] Nobody in the building can say what a new medical encounter costs, because the med…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
New patient volume is short of plan
[COS] "The phone rings, we're just not closing." Consult slots go unfilled, the injector has time, inquiry volume is steady, and the working theory is that the market has softened. [MED] "We're booked eight weeks out and we still can't grow" — the medical sche…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
Growth has plateaued
[MED] "We're seeing as many patients as we ever have and collections are flat." Booked six weeks out, the extenders' columns are solid, actinic-keratosis and biopsy volume is up year over year, and nothing shows up in the deposits. [COS] "Cosmetic was supposed…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
Performance varies by location
Eleven sites, one intake script, one fee schedule, and cosmetic revenue per location that varies by a factor of four. The medical side varies just as much between physicians inside the same building. Nobody can say whether it is the market, the provider, or th…
5 CAUSES · 5 TESTS
WORK IT THROUGH → -
Preparing for sale
Twelve to twenty-four months out from a process. The medical line's economics rest on one or two Mohs surgeons, and the cosmetic line is a set of relationships rather than a documented funnel. "How much of this survives me?" is the diligence question, and righ…
5 CAUSES · 5 TESTS
WORK IT THROUGH →
WHICH ONE
How to tell which one you have
These five overlap, and two or three usually apply at once. The order to read them in is set by which number actually moved. If cost per new patient moved, start there. If demand held and bookings did not, start with the volume page. If nothing moved at all, start with the plateau page — and if the group total looks acceptable while one site keeps coming up in conversation, read the variance page first, because a pooled number is structurally incapable of showing you what you are looking for.
Every cause on every page above carries a measurement you can run in your own systems, with the finding that confirms it and the finding that rules it out. Run two or three before you brief anybody. If the tests tell you this is not a marketing problem, that is the correct answer and it cost you nothing.
RESOLUTION
What resolves each, and what resolved looks like
Each presentation resolves to a different part of the work, and the pages say which: reporting and attribution where the finding is a measurement error, conversion and desk work where the loss is between the inquiry and the admission, acquisition where the demand genuinely is not there, and pre-sale work where the question is whether growth can be re-run by somebody else.
Each also carries what resolved looks like as a number — the measure, the published median, the top decile where an honest one exists, and a target range — with the source in the row. Where no credible distribution is published, the page says so instead of borrowing one from an adjacent specialty. That absence is itself a finding: it means your own trailing history is the only benchmark worth measuring against.
WHERE YOU STAND
Reference ranges for dermatology groups
See also where you stand and what decides the outcome before any of this is treated.
A differential narrows the list. It does not close it — that is what the examination is for.
APPLY — 6 / QUARTER →