IV's At Your Own Home
To start off, my name is Dr. Taylor Graber. I am an MD physician from the San Diego area. The bulk of my medical experience and practice revolves around Anesthesiology, which is the medical practice responsible for “helping patients go to sleep” for surgery. This comes in many different forms, from sedation for procedures such as colonoscopies, nerve blocks to help with pain, and to general anesthesia for trauma surgeries and transplants. In all of these different areas, the most reliable way to provide anesthesia is through intravenous (IV) catheters.
hese allow us to provide fluid, medications, or anything else we need, directly to the heart and ultimately to the rest of the body. Throughout my time doing anesthesia, it was easy to see the direct benefit that IVs can give patients, and for a variety of issues. I started ASAP IVs to provide a medium to give clients the ability to experience the benefits of IVs, and of proper hydration, without the time and hassle of going to a hospital and emergency department. Some people wonder why it is necessary to get an IV, and we have helped answer this question with some blog articles [here](https://www.asapivs.com/blog/why-iv).
ASAP IVs provides a client with the ease of receiving an IV treatment in the comfort of his/her own own. We come to them, providing the session when it is most convenient. While we are not a substitute for emergency medical services (and would always recommend getting professional medical treatment at a hospital if there is any question that the underlying issue is life threatening!), our IV treatments are very safe and effective. Our clients have used our services for a number of different issues: maintaining optimum hydration before and after heavy exercise, boosting the immune system during cold and flu season, treating inflammatory conditions such as viral gastroenteritis and fibromyalgia, and even IV hangover recovery (which is one of our specialties!).
The visits are easily [scheduled online](https://www.asapivs.com/scheduling) using our website. Once a time and IV therapy package are selected, a brief medical history is completed (which is ultimately reviewed by me as the physician of our company) which ensures that the IV treatment would be safe for the client. Once this is approved, a physician or nurse will come to the clients house to provide the IV service. This can be quiet and discrete (on a couch watching Netflix) or a group event as part of a bachelor party (poolside IVs!). The IV takes less than a minute to place, and the infusion takes ~30 minutes to complete a 1 liter infusion. All of the medications, vitamins, and supplements can be safely administered together, so there only needs to be one poke!
The gold standard of medical literature rests in what are called "randomized controlled trials". What these involve are different steps to take an intervention (say giving one group of people IV fluids and another Gatorade) to two different groups and observing the change in their symptoms in response to the intervention. These can be blinded, such as single-blinded, double-blinded, or triple-blinded, depending on how many people in the study know which subjects received which treatment. To date, there have not been any major studies to compare IV fluids to a non-IV fluid group. However, a quick search of "IV Hangover cure" on Google will show hundreds of different blog articles where bloggers get the treatment themselves after a night of partying with[ immediate results such](https://greatist.com/live/recovery-iv-hangover-cure#5) as "yeah it totally worked; for the rest of the day, I had no headaches and no nausea"
These anecdotal results are not the most firm scientific literature, but then again, neither is a friend's glowing review of a popular restaurant, but does that sway your opinion from eating there? Whenever you are severely hungover and unable to get up off your couch, you want something that is going to work, and IV hydration does that, QUICKLY. Many of our clients have stated they feel immediately better after 5-10 minutes of an IV starting (which is only after 200-300cc of a 1000cc bag!!).
In fact, a popularly cited[ study](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2894814/pdf/acm.2008.0410.pdf) looking at IV fluids in relation to the placebo effect had 34 patients with Fibromyalgia randomized to either an IV fluid package with only IV fluid and electrolytes, versus an IV fluid package with a cocktail of vitamins (called a Myers' Cocktail, including Magnesium, Calcium, Vitamin C, B vitamins). The results of the study found that all patients in the study felt better after the treatment! While there was not a statistically different effect between the two groups in treating fibromyalgia (there were only 35 patients in the study and it was likely under-powered to detect a statistical difference), the fact that in this study all patients who received IV fluid improved is a testament to how helpful IV fluids can be.
Fortunately for me, IVs have been a tried and true method which has been well-validated over the last century in the medical community. The novelty of [ASAP IVs](https://www.asapivs.com/) is that our company provides these effective medical treatments, in the comfort of your home. Personally, I have had IVs for a number of different issues, and so I knew that personally, they would be effective and well-received. My background as an MD physician was the easy part in deciding the medical needs, but the difficult part was marketing the material to future clients. As a small business owner, I took on many of the responsibilities at once: building and maintaining the website, online promotion through social media, outreach and marketing to local businesses.
At the beginning, I wanted to get new clients as organically as possible. I didn't want to drain the entire budget on paid advertising. I started with our website, a Google business page, a Yelp page, and our Instagram page. Our first client actually came as a referral from our Yelp page (it turns out, our new website didn't populate that well organically on Google, but "IV Hydration" on Yelp was the third listing, and our new company ranked much better there). Our first clients were provided package bonuses and future discounts for referring new clients, which helped introduce the next wave of clients, and both the online reviews and word of mouth further accelerated the growth.
The customer service experience is always at the very center of everything we do. I have always wanted it to be easy to find the necessary information on our website, have a straightforward scheduling process, and deliver a best-in-service customer experience for the IV treatment. If there was any deviation from this expectation, I wanted to know about it, so that I could gather feedback and implement changes as quickly as possible. It was very important for me to get honest feedback from clients either in person or from an email, so that we could ensure our customer experienced was lining up with our expectations.
As a "disruptor" in part of the medical field, we are fortunate that the initial startup expenses are drastically lowered by the fact that we are a mobile company. We have no fixed costs for leasing a brick-and-mortar location, which enables us to run financially lean. This allows me to charge less for our IVs compared to our competitors, and pay our nurses more for their work during the IV sessions. Given all of this, we have not had to raise external money, as we have been able to provide all of the capital for startup and ongoing expenses internally and from revenues from business transactions.
As I mentioned previously, the customer experience is at the center of our business model, and tailoring to our demographic is part of that. Looking at the data from our mobile visits, we have an equal split between males and females, and also between single visits and group IV hydration sessions. There are just as many clients who book an IV for themselves as there are 3-4 clients who want to rehydrate together. The age demographic is wide, from as young as 20 to as old as 60s, although the most common is 25-40. Given this information, and in an effort to continue to connect to our demographic, Instagram and online marketing continues to be at the center of our client outreach.
Instagram seems to be one venue which works well for easily placing content into a similar demographic, both by organic and paid posts, and it has been an ongoing effort to continue to make an effect Instagram model. We also have an outreach program to put our brand in front of the eyes of our client demographic. We are in the process of establishing relationships with other local companies and host pop-up events at their business locations, so that we can offer benefits to their customers but also establish awareness of our brand.
Given that our company is medically oriented, and that IVs are a medically necessary procedure that can provide immediate benefit, there is a balance which requires delicate screening in the scheduling of the visits. While more than half of our IV sessions are for healthy clients who are looking to remain healthy (fighting off future illnesses, maintaining an optimum level of hydration, recovering from a marathon or heavy endurance event) the other half are those in more distress and a need to recover from an acute ailment. Frequently, these are benign causes, such as bad hangovers or viral illnesses, but sometimes they can be of a more sinister nature (appendicitis).
Since we are a mobile company without a diagnostic capacity (such as a hospital or emergency department), we have to rely on medical training and intuition in ruling out which clients can be treated safely with a home IV and who should really be referred to a higher level of care. This is rare, but has happened, and is why it is critical for the visits (including the presenting symptoms and relevant medical history), to be reviewed by a qualified physician before each visit.
In the early stages of our company, I was the only provider. As a qualified MD physician, I was able to screen the visits for their medical necessity, go to the home/apartment/office of the client, place the IV and monitor for side effects, and complete the follow up. However, as I started this company as an addition to my full-time career in Anesthesiology, the timing for visits was limited to times where I was not already occupied. As you can imagine, this drastically limited our availability to schedule additional clients and perform outreach events. In order to scale and accommodate more clients, we needed to increase the staff of our team, so that we could increase our marketing and also fulfill the additional volume of visits.
As a physician working in hospitals, there is no shortage of people to meet. Hospitals are some of the most densely staffed businesses in each city, and there are accordingly a lot of nurses who I am able to be acquainted with, and I was successful at gaining the first few members of our team from my already existing personal network. From there, we were able to build off of their relationships for additional hiring needed, as well as including a relevant hiring "Contact Us" location of our website.
Contrary to what the initial market survey indicated, our most common IV therapy is actually not always the IV Hangover. There is actually a considerable benefit that patients can get from IVs when you are not acutely ill. Vitamin C and Zinc can help prevent episodes of cold and flu vital illnesses during the winter months, and these effects can [even be more dramatic](https://www.asapivs.com/blog/brass-tax-vitaminc) in individuals who heavily exercise or train for marathons. Our IV supplements can improve focus, decrease fatigue, and help recover from fibromyalgia and other inflammatory illnesses. The ASAP Myers' Blend can potentially decrease asthma exacerbation frequency.
The most common type of [IV service](https://www.asapivs.com/ivtherapies) varies month to month. The IV Hangover is definitely the most popular during the summer months, with vacationers and bachelor/bachelorette parties along the beaches of San Diego. The ASAP Immunity Booster has been the most common during the winter months, both in recovering from and preventing viral illnesses. Our IV therapies range from $150-225. There are no other fees or delivery charges, so the prepaid price is the final cost seen by the client.
The background of pursuing a career in medicine doesn't include very much information on being an entrepreneur. Even though many physicians own and run their own practices, there are no formal business lectures during medical school, and physicians who have an entrepreneurial nature have to either be entirely self-taught, or contract the appropriate outside services.
In medical school, I started by first "business", which involved tutoring and mentoring college-aged students who were looking at applying to medical school. I assisted them with how to look at the admissions process and tailor their application and experiences to best optimize themselves for success, and charged an hourly fee. Medical school was very busy to say the least, and I didn't have enough time to fully devote to this startup. Unsurprisingly, it never really took off, but I do believe it provided me some valuable lessons which I took into ASAP IVs.
While I don't have many members of my family who are in the medical field, I do have several who had experience in starting their own small businesses and companies. I was able to draw on some of their knowledge in starting and running companies and combine it with my own medical knowledge to position ASAP IVs for success. Although many were surprised that a full-time physician could find the additional time to start a new small business, I luckily had a lot of positive encouragement from those around me, especially those who had previously started businesses themselves. Their insights from early years were very helpful in getting me started as well.
Starting a business hasn't been easy, especially when it has been separated from my primary job. There have been growing pains in outlining the business and legal structure, filing the appropriate federal, state, and local paperwork, technology issues, and many others. I had the benefit of being able to grow ASAP IVs at its own pace, and not rely on its revenue stream as my only source of income. This allowed me to keep more money in the company, and reinvesting in its success, which has certainly helped our growth.
I have a competitive nature, and I am motivated to not only improve the customer experience delivered by our company, but to be better than our competitors as well. I want to deliver a better quality product at a better price than the companies surrounding us. When I think about falling short of that goal, it certainly motivates me to improve. It motivates me to seek sources of change, and to implement them quickly. The end goal is that I want our customers to have the ASAP IVs name, brand, and image be synonymous with top-notch service, and the go-to name for our field of IV hydration.
One of the biggest lessons I have learned in starting ASAP IVs, is that there is a palpable divide between time and cost with nearly every decision that is made. If there was something I wanted to do or change with the company, and I didn't want it to be expensive, I had to learn how to do it myself, or find the right person to help. This was not as costly, but it took significantly more time. The alternative would have been paying someone else who was an expert in that field, which would have resulted in changes much more quickly, but drained the budget much quicker in the meantime.
Comparing our company to the others in the IV hydration space, both in San Diego and in other cities, it is evident that marketing is the biggest factor which is preventing us from rapid growth. I want our company to gain market share and continue to earn the trust of new clients, but not do so in a manner that cheapens the overall product or diminishes the customer experience. In order to do this, we first slowly increased the amount of providers who work for our company, so that our infrastructure could support more visits. Now that this has been accomplished, and we have more availability, we are continuing to increase our digital presence from Instagram and Google SEO, at the same time as building mutually beneficial partnerships with local companies.
I try to have our company run as streamlined and efficiently as possible. In the modern age with cell phones and apps, this is much easier than it would have been 20+ years ago. Our website is managed through Squarespace. The scheduling is currently managed through Acuity Scheduling. This has worked very well for us. The access and availability, including the ability to quickly make changes through the Acuity Scheduling app, is critical for our success. We use Square for our payment processing, both via Acuity Scheduling, and for in-person payments, pop-ups, and add-ons. The real-time data this provides, the mobile menu, portability, and ease of use across all of our IV providers makes this particularly valuable. I also frequently use data and analytics from Google Analytics, Squarespace Analytics, Google Ads, Google My Business, Yelp Biz, and Mail Chimp which help gather information about how well we are running and areas for potential improvement.
Our company is very young. I founded the company in 2019, and we had our first customer earlier this spring. We have navigated from a single provider with limited availability, to a team of 6 providers and daily scheduling. This has dramatically increased our volume and involvement/satisfaction of our team. We have increased our volume each successive month this year, and hope to sustain that trajectory of growth. We just celebrated our 100th IV visit/client. In 2020 we are looking to increase our foothold in San Diego, but we are also looking at expansion back to my home state of Arizona. Our revenue has been in the low 5 figures, and we hope to drive that to a 3-4x multiple with sufficient growth in 2020.
From a technical standpoint, improving our organic traffic through improvements in SEO and organic instagram following are my biggest sources of focus. I believe this will translate additional new clients and future success, both in San Diego and in Arizona.
I am very enthusiastic and passionate about ASAP IVs and its future/growth, and I do not have any current plans or needs to sell the company. I want to continue to increase our volume, deliver an excellent experience to our clients, and promote a positive work atmosphere for our nurses. However, should the opportunity arise where someone wants to purchase the company, I would give that opportunity the chance it deserves and fully evaluate the proposal.
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