Hey Reader,

Here's something almost every small practice gets wrong:

They price out a Telehealth visit by what they can see. Their time. The platform fee. Maybe add a little for overhead.

What they don't price is the cost of running healthcare on tools that were never built for it.

That cost is real. It's steady. And for most solo and small-group practices, it's meaningfully larger than the line items already on the books.

The DIY stack isn't free. It just bills you in a different currency.

Here's where it actually shows up:

You're paying for compliance one way or another. A properly configured HIPAA-compliant stack runs $150–$400/month across all vendors. You can get HIPAA Compliant Zoom from Secure Telehealth at less than that even and we'd be able to help you with your other tech questions. A non-compliant one runs $0 — until OCR knocks. Penalties start at $137 per violation and climb to $2M for willful neglect. Doing it right costs $2–4K a year. Doing it wrong costs zero, until it costs a whole lot more.

Tech failures cost more than you think. A dropped session isn't a free event. It's a rescheduled visit, a probable copay write-off, a patient less likely to rebook, and 20–30 minutes of cleanup. Call it $200 an incident. Most practices I audit are running 2–5 of these a month before I touch anything. That's $4,800–$12,000 a year that you'll never get.

After-hours admin is unreimbursed labor. Charting at 9pm. Prior auths Saturday morning. Reconciling no-shows the reminder system never sent. At a $200/hour clinical rate and one extra hour a day — low end for the practices I see — that's $52,000 a year in time you're not getting paid for.

Cognitive load is the tax no one talks about. Every time you have to wonder whether something is compliant, whether the new vendor is "OK," whether the chart synced — that's attention not on patient care. Clinicians describe it as a low-grade hum that never quite goes away. You can argue about the dollar value. You can't argue it's small.

Here's what changes when this gets professionalized:

Not flashy software. Something duller and better. A consolidated, fully BAA-covered stack where every tool talks to the next. Devices encrypted at rest. An incident response plan that fits on one page. Backups tested monthly. A phone number that picks up. One person whose job it is to keep the boring parts working.

The decision is where you want to pay the cost. You will pay it. The only question is whether you pay in dollars — where it's small and visible — or in time, attention, and risk, where it's large and hidden.

If you want a second pair of eyes on where you stand, I do free 15-minute audits for clinicians considering changes. No pitch, just an honest read. Link below.

It's worth 15 minutes of your time.

— Dan

Telehealth Success System

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