Almond Doctor: Empowering Institutional Physicians through Multi-Point Practice to Create Added Value [2018 Primary Healthcare Innovation Summit]

Martin, Founder of Xingren Doctor, Delivers Speech on “Innovation in New Clinic Models: Co-Created Partnership Clinics by Physicians”

Conference: 2018 Summit on Innovative Practices in Primary Care

Venue: Landison Plaza Hotel Hangzhou, Zhejiang

Speaker: Martin, Founder of Xingren Doctor

Almond Doctor is China’s largest platform for physicians’ multi-site and independent practice. Martin, the founder of Almond Doctor, previously served as a military physician in the United Nations Peacekeeping Forces, General Manager of Business Development at Siemens Health Services, and General Manager of United Family Healthcare. The Almond Doctor platform he founded secured RMB 200 million in financing in 2015, marking the largest Series B funding round for any mobile health project at that time. Since its launch late last year, Almond Doctor has facilitated 1,531 surgical procedures. The platform currently hosts 430,000 verified physicians and covers 23,869 medical institutions across China, with a scale of physicians and healthcare facilities comparable to that of Europe’s largest country. At the New Clinic Forum of the 2018 Primary Care Innovation Practice Summit, the founder of Almond Doctor shared insights on the value and future prospects of physicians’ independent practice.

VCBeat (WeChat: vcbeat) has compiled Martin’s insightful perspectives, which are primarily divided into four parts.

I. The Core of Future Healthcare Lies in the Power of Physicians

II. Multi-site Practice by Physicians Is a Rational Arrangement within the Healthcare System

III. Physician Co-Creation Partner Clinic Model: Shared Risk, Shared Rewards

IV. Three Key Elements for the Success of the Business Model of Physician Practice Platforms

1. Outpatient Investment: An Investment Model Aligned with Physicians’ Interests

2. Clinic Operations: High-Quality Healthcare Affordable for the General Public

3. Outpatient Services: Building Platform-Based Clinics Capable of Delivering Closed-Loop Services

There are three main roles in healthcare services: the government, physicians, and outpatient clinics and hospitals. Within the public system, these entities are integrated into a single organization known as public hospitals. In the non-public system, however, these three roles are distinct: the government serves as the leading authority, physicians provide clinical services, and clinics and hospitals function merely as platforms. Who ultimately resolves patients’ health issues? Is it the media? No. Is it the government? No. Is it the outpatient clinic? No. It is the physician. Physicians are the core of the entire healthcare industry. Therefore, if we consider how to discuss healthcare and implement new healthcare models within the non-public system, we must first focus on enhancing the value of physicians and addressing their challenges. By doing so, we may be better equipped to resolve patients’ problems.

Only when doctors are respected and achieve a healthy work-life balance can they better serve their patients. This is also an industry imperative. Since 2016, we at Xingren Doctor have been establishing offline clinics for physicians and launching the Xingren Doctor platform, which has been warmly welcomed and positively received by the medical community.

Medical practice is rediscovering the value of physicians, a trend that will undoubtedly shape the future of healthcare. This trend is evident in several areas. First, multi-site practice is a direction strongly advocated by national policy. As a supplement to public hospitals, emerging medical models operate differently from the integrated public hospital system. In public hospitals, the institution provides infrastructure and covers costs, while clinical processes are strictly regulated by the government. This constitutes a "power-driven" medical model focused on delivering basic healthcare coverage, which inevitably leads to the challenge of meeting substantial demand with limited resources. In contrast, within the non-public sector, lacking government support, all medical institutions must establish and implement their own sustainable business models. Xingren Doctor focuses specifically on the physician community. Regarding multi-site practice, we have observed that the government has issued over 120 policies related to this practice. Therefore, it represents a critical strategic area. Under this government-led framework, physicians are empowered to develop their own multi-site practices.

Secondly, by examining physicians’ needs, we can also envision the future of multi-site practice and independent practice. Under the current healthcare system, it is unrealistic for physicians to engage in fully independent practice by working five days a week in their own clinics. No physician has a patient volume sufficient to fill five days, nor is there an established payment mechanism in place, unless one possesses exceptionally strong personal branding and operational capabilities with an independent patient base. However, multi-site practice offers a viable alternative: a physician might work three to four days per week at a public hospital and spend one day at their private studio, earning three times as much on that single day as during the preceding four days combined. This illustrates the value of multi-site practice and represents today’s opportunity. One of my closest friends, a chief of vascular surgery in Australia, earns AUD 500 per day within the public healthcare system. Outside the system, he works just one and a half days per week and generates nearly RMB 10 million annually. Why does he remain within the public system? Because he genuinely enjoys serving patients. Physicians do not work in hospitals solely for financial gain, but such an arrangement is reasonable, providing them with opportunities to supplement their income. Moreover, this approach helps retain physicians within the public healthcare system, which is a significant advantage.

The distinguishing feature of Xingren Doctor is its ability to provide physicians with a comprehensive platform that covers the entire care continuum—from pre-consultation, in-consultation, and post-consultation stages to appointment scheduling, laboratory and diagnostic testing, surgical procedures, prescription issuance, follow-up visits, and medication management. I offer an all-in-one solution for doctors. Many platforms available to physicians merely facilitate prescription services, addressing only commercial transaction processes. As a physician myself, I view my profession as akin to carpentry: if you hand me a screwdriver but not a power drill, I cannot complete my work efficiently. Similarly, providing doctors with only a tool for prescribing medications does not constitute a professional practice platform; it merely supports outpatient consultations. Therefore, our integrated supply chain—encompassing not only traditional Chinese medicine and genetic testing but also other essential resources—empowers physicians to effectively carry out their clinical duties.

Almond Doctor is positioned to serve physicians by providing a comprehensive personal practice platform. In 2014, we were the first to launch a SaaS/CRM studio platform for doctors, at a time when many others were still offering platforms for appointment registration, outpatient services, and social networking. The platform has 430,000 real-name verified physicians. In 2016, we pioneered the WeWork-style shared outpatient clinic model. The “WeWork model” refers to an operational approach in which Almond Doctor handles all cumbersome tasks—including site selection, design and renovation, equipment procurement, license applications, and staff recruitment—to fully build, maintain, and manage a standardized outpatient clinic. Physicians can then practice at multiple locations directly, sharing their medical practice revenue with Almond Doctor.

In 2017, we expanded to Shanghai, Guangzhou, Chengdu, and Shenzhen, where we jointly established four comprehensive outpatient clinics with physicians. Almond Doctors primarily operates as a multi-site practice platform for physicians, targeting the blue-ocean market of medical services. As these comprehensive outpatient clinics were rolled out, Almond Doctors introduced the concept of “Physician Partners.” Under this partnership model, Almond Doctors and the physician partners jointly contribute capital, co-manage operations, share profits, and assume risks together.

From a business model perspective, it is challenging for individual physicians to establish and sustain their own private practices, as they bear all costs personally. Many are unaware of how many physicians have attempted to open their own clinics only to struggle with limited patient acquisition. In contrast, since joining our platform on day one, they have been profitable. By utilizing shared spaces where examination rooms are allocated to different physicians at different time slots—allowing for flexible, on-demand use—we enhance the efficiency of physicians practicing at multiple sites. This approach reduces outpatient operational and investment costs, thereby maximizing revenue for both individual physicians and physician groups. We offer personalized configurations to create a tailored practice experience for physicians, ensuring a pleasant and productive collaboration.

Why Has This Model Succeeded? It Features Three Key Characteristics: First, the Outpatient Investment Model; Second, the Outpatient Operations Model; and Third, the Outpatient Business Model.

We provide physicians with comprehensive, high-standard medical equipment. All equipment used by Xingren Doctors is domestically leading. In fact, public hospitals typically have the best equipment. However, for our shared medical facilities, we can purchase either domestically produced or imported equipment. I do not refuse any physician’s requests; however, everyone is rational. If you choose imported equipment, how much will your cost allocation be? If you opt for domestically produced equipment, what will your cost allocation look like? It is that simple. You will find that once interests are aligned, physicians’ attitudes change immediately.

This is the investment logic for internal clinic funding. In terms of attracting external financing, our secret lies in the homophonic wordplay of “Xingren Yisheng” (Almond Doctor), which sounds like “Xinren Yisheng” (Trusted Doctor). Our outpatient partner recruitment campaign, launched in March 2017, raised RMB 15.96 million from 257 partner physicians within just 30 days. Why did we raise such a substantial amount? Because we shared platform benefits with physicians, who in turn invested their own capital with us. It is unprecedented to hear of physicians investing their personal funds into a platform; this demonstrates their trust in us.

Operations of the Second Clinic. Our most distinguishing feature: While Xingren Doctor is positioned for the general public, we provide renovations and an environment comparable to those of high-end clinics. Regarding physician qualifications, all doctors at Xingren Doctor are incumbent specialists from tertiary hospitals, rather than former employees hired after resignation. Xingren Doctor’s positioning centers on physicians’ multi-site practice. All fees, excluding the physicians’ own consultation fees, are identical to those at Grade 3A hospitals. Your operational model encompasses more than just IT systems or Hospital Information Systems (HIS). Software alone cannot resolve any issues; you must apply managerial thinking. Therefore, I believe that every aspect—from hardware and management models to IT—is critically important. Both management models and strategic approaches must be systematized.

Many of our peers have pivoted to opening physical clinics in the past two days. Prior to launching its own clinics, Almond Health had already established a three-year foundation in online operations. We did not undergo a transformation; rather, we extended our business from an online-light outpatient model three years ago to offline services today. Since day one, Almond Health’s strategic direction has remained unchanged: previously, physician services were delivered online, and now they have been extended to offline settings.

Closed-Loop Outpatient Services: China’s Largest Platform for Physician Practice Management. Today, I will present the second aspect of new-style healthcare: what is our model? A traditional outpatient clinic might have five physicians with a business target of serving 1,000 patients. In contrast, an Almond Clinic may engage 200 physicians, each seeing five patients, also totaling 1,000 patients, thereby delivering equivalent commercial value. Therefore, what is the prerequisite before we open each clinic? We must have a sufficient number of physicians in every city. The foundation of our outpatient business is substantial physician traffic; our large physician base in every city constitutes our moat, which is difficult to imitate or surpass.

The 2.0 Model of Xingren Clinic: Extending the Service Loop Once AgainUnder the 2.0 model of Xingren Clinic, the service loop has been further extended. The Day Surgery Center performs surgical procedures for patients, while all subsequent follow-up visits and medication management are completed entirely on the platform. Preoperative laboratory tests and examinations are completed within three days prior to surgery. After discharge, all postoperative care is delivered through the platform. Furthermore, our pricing is comparable to, or even lower than, that of hospitals.

HIS systems. I consider this to be fundamental work. The platform has partnered with physicians in many cities. In reality, the primary role of physicians is to provide high-quality patient care, focusing on clinical knowledge, clinical learning, and research, rather than determining how much patients should pay or what the price of medications should be. This is the issue that Xingren helps physicians resolve. If you visit Xingren’s operating rooms, you will find that every piece of gauze and every pair of scissors is identical across all facilities. Management is critically important, and I believe ensuring such a consistent level of quality represents the greatest challenge in the industry; it is quite difficult to achieve. In contrast, if you observe some established outpatient clinic brands, you will notice that each location operates differently, with varying management models and procurement processes.

We only opened our doors at the end of last year, have broken even to date, and have completed 1,531 surgeries on the platform.

Many players in the internet healthcare sector are also engaged in fraudulent practices, but we are shifting our focus to offline services to truly serve patients well. We believe that moving offline allows us to clearly distinguish between “teams that get things done” and “teams that are just good at talking,” a critical issue that must be addressed in serious medical care. Under the model exemplified by Xingren (Almond) Doctor, the role of physicians is clearly defined: to cure their patients. Xingren Doctor assists physicians in managing their practices and leading their teams, with the aim of working together with doctors to transform the future of healthcare. Thank you all!