How could you guarantee you never fill your patient panel?

Strange question, I know. But stay with me…

I recently came across an idea from Charlie Munger that completely reframed how I think about growth. 

His "inversion rule" is simple: instead of asking how to succeed, ask how to fail, and then systematically avoid those mistakes.

When you apply that lens to your practice, something interesting happens. 

The problem becomes clearer. The friction becomes obvious. And the things quietly holding you back are suddenly hard to ignore.

In this post, I'll walk you through that inversion exercise and what it reveals about the hidden barriers to filling your patient panel.

Who was Charlie Munger?

If the name doesn't ring a bell, you've almost certainly heard of his business partner Warren Buffett. 

Munger was vice chairman of Berkshire Hathaway, a brilliant attorney, and the architect of much of Buffett's investment philosophy.

His approach was refreshingly simple: focus less on chasing brilliance, and more on avoiding stupidity. He was patient, disciplined, and obsessed with identifying what not to do.

His inversion rule captures that perfectly. 

Flip the question. Solve it backwards.

The inversion exercise: how to guarantee you never fill your panel

To test the inversion exercise, I sat down and asked myself: 

If I were opening a direct care practice, what would I do to guarantee I never filled my patient panel?

In all honesty, the answers weren't surprising. 

But something about flipping the question made them land differently. Suddenly these were things I couldn't brush past or explain away.

Some of these you'll recognize immediately. Others might hit a little closer to home. 

The point isn't to overwhelm you. It's to shine a light on the things we often rationalize, deprioritize, or simply don't see when we're deep in the day-to-day of building a practice.

• Target everybody instead of somebody. Generic messaging speaks to no one. If it's unclear who your ideal patient is, your marketing will be easy to ignore.
• Be invisible. No website, no Google listing, no reviews, no social presence. If a patient can't find you in 10 seconds, they'll move on.
• Never explain your model. If you don't explain how direct care works, patients will fill in the gaps themselves… and the story they create won't be a flattering one.
• Keep pricing vague. Buried or unclear pricing signals one of two things to a potential patient: too expensive, or not trustworthy.
• Make signing up complicated. Multiple platforms, scattered steps, and putting the burden on the patient to remember what's next is a reliable way to lose them.
• Be slow to respond. Speed equals trust. Delays signal disorganization or disinterest.
• Mimic insurance-based communication barriers. Phone trees, unreturned voicemails, no texting or email… if it feels like a traditional practice, patients will wonder why they're paying a membership fee.
• Avoid community engagement. No networking means no relationships, which means no referrals and no growth.
• Make onboarding clunky. If a patient does sign up and the experience feels difficult or disjointed, they won't stay long.
• Price based on your ego or your peers. Basing your price on your credentials or what others charge puts the focus on you — not on the value the patient receives.

It all comes back to three things

Every single mistake on that list traces back to one of these three things:

Trust — Are patients confident you're the right person for them? Trust is built through clarity, responsiveness, and professionalism. It's damaged by vague messaging, slow replies, and anything that makes a patient feel like they have to figure you out on their own.

Convenience — How easy is it to find you, understand you, and sign up with you? Every unnecessary step, every moment of confusion, every time the patient has to chase you is an opportunity for them to walk away.

Perceived value — This isn't about what you think you're worth or what your peers are charging. It's about the transformation you're promising the patient. If they can't clearly see what their life looks like on the other side of working with you, the price will always feel too high.

When something isn't working in your practice, it's almost always a breakdown in one of these three areas. 

The inversion exercise is useful because it forces you to look at each one honestly and ask where the cracks are.

Key Takeaway

The inversion rule doesn't replace positive thinking or goal-setting. 

But it does force you to confront the things you might be glossing over. 

The low-hanging fruit you keep deprioritizing, the friction you've stopped noticing, and the gaps you're leaving for patients to fill in.

So here's the question to sit with: what are you doing right now that, if you're honest, is actually a strategy for failure?

Ready to dig deeper? Listen to this week's full episode for the complete inversion exercise. And if any of this hits close to home and you're not sure where to start, let's talk. Reach out at [email protected]. I'd love to hear what you're navigating.