Module 1 Know your customer and market 4 hAnalyse
Every sound business in health begins with one clear customer and one clear problem. In São Paulo and the wider state, demand is real but crowded, so a small, well-described customer group wins before a broad one.
- In health: Describe the person by need: prevention, a chronic condition, or recovery; each has a different service rhythm.
- Write the customer in one sentence: a patient or member of the public. Add the place, the moment of need and what they use today.
- List five rivals or substitutes within reach. For each, record price, strength, weakness and how people reach it.
- Interview at least eight real customers with open questions. Record exact words, not your summary.
- Count the market in units: how many visits could one area buy in a month? Use two public sources and your own count, then take the lower figure.
- Choose one first segment and say why the others wait.
Worked example. Weak: 'Everyone needs a health or wellness service.' Strong: 'Our first customer is a patient or member of the public within 8 km of the centre, who today pays R$ 198 per visit and complains about delay. We target 132 visits a month by month three.'
Second worked scenario. Scenario: ten customers are interviewed for health. Seven say price, two say speed, one says trust. Question: which first message do you write, and which interview record backs it? Model answer: lead with the visit price and speed promise, keep trust proof as the second line, and cite the seven price answers by date.
Activity. Write the one-sentence customer, a five-row rival table and eight interview records. Share them with a peer for a challenge round.
Standard to meet. Define a specific customer, build a rival table with prices, and trace every claim to an interview or a source.
Module 2 Rules, registration and data duties in Brazil 4 hUnderstand
Brazil asks every trader to be visible and accountable. Know which register, tax regime and sector rules apply before the first sale, and check each against the current official text.
- In health: Health services answer to the health surveillance system (ANVISA rules, applied by state and municipal health surveillance offices) and to professional councils; confirm the licence for your service before advertising.
- Choose a legal form: micro-entrepreneur (MEI) only if your activity appears on the official MEI list, or a company registered with a CNPJ. Regulated activities need their sector authorisation first. Check the current limits and lists on the official portal.
- Learn the tax regime that fits your size and write down which taxes you will collect and pay, and when.
- Find the sector rules for health: licences, inspections, professional registers. List each with the office that issues it and the renewal date.
- Personal data of customers falls under Brazil's data protection law (LGPD). Collect only what you need, say why, keep it safe, and name who answers questions.
- Consumer law gives buyers clear rights on information, returns and complaints. Put your terms in plain Portuguese.
Worked example. Checklist for a new health trader: 1) legal form (CNPJ, or MEI only if your activity is on the official list); 2) city operating licence; 3) sector licence or register; 4) tax set-up; 5) privacy notice; 6) written terms. Each has an owner and a date.
Second worked scenario. Scenario: a neighbour says registration can wait until the first R$ 900 of sales. Question: what do you do? Model answer: do not delay; write the compliance table first, confirm the register, tax and sector licence with the official office, and start only where the table shows no open blocker.
Activity. Build your own six-line compliance table for your first location. Mark what is done, what is pending and who confirms it.
Standard to meet. Cite an official source for every line, assume nothing, and date every pending item. Local law always wins over this course.
Module 3 Design the offer 4 hCreate
An offer states what the customer gets, how well, by when and at what price. For a health or wellness service, the offer must make the quality visible and the next step easy.
- In health: Offer care pathways with a clear first visit, follow-up date and a plain written plan.
- Describe the core offer in three lines: what is delivered (a health or wellness service), the standard it meets, and the time it takes.
- Add one proof for each promise: a sample, a test result, a guarantee or a customer record.
- Price from cost upward and from customer value downward, then pick a price inside both.
- Write a simple one-page terms sheet: what is included, what is extra, how to cancel.
- Create two options at most, so choice stays easy.
Worked example. Offer: 'A health or wellness service, delivered within agreed time, checked against a written standard, price R$ 180 per visit. Proof: a dated record the customer can check and sign. Changes or cancellation by written agreement before work begins.'
Second worked scenario. Scenario: a customer asks for a discount from R$ 180 to R$ 162 per visit. Question: decide with numbers. Model answer: contribution falls from R$ 100 to R$ 82 per visit; offer an extra of value (for example faster service) before cutting price, and accept only if the lower contribution still clears break-even.
Longer notes. Define the visit as a package: the type of appointment, its length, who attends, what supplies are included and what is booked separately, such as laboratory tests. Write the preparation the patient must do and the document the patient receives afterwards. Work out the cost per visit from clinician time, disposable supplies and cleaning of the room. Keep rent, equipment and the reception salary as fixed cost. Test the schedule with ten real appointments and note delays. Before you open, confirm the licence your rooms need and how the rules protect patient records.
Extra worked example. A visit is sold at R$ 180. Supplies cost R$ 20 and the clinician's time R$ 60 (a worked-example split, not market data), so its own cost is R$ 80 and each visit leaves R$ 100, a margin of 55,6%. At 220 visits a month, revenue is R$ 39.600 and contribution R$ 22.000. After R$ 14.000 of fixed cost, the result is R$ 8.000. Break-even at 140 visits, 64% of the current volume, leaves a cushion of 80 visits before a month turns negative.
Activity. Write the offer card, the proof list and the terms sheet. Test them with three customers and note every point where they hesitated.
Standard to meet. Check that promise, proof and price are consistent, fit the terms on one page, and record three customer reactions.
Module 4 Run the work step by step 5 hApply
Good operations make results repeatable. For health, write each step so a new person could follow it on their first day, and measure each step.
- In health: Use a consent and records routine: identity check, history, plan, signature, secure storage.
- Map the process from first contact to paid and closed. Typical stages: enquiry, quote, preparation, delivery of the visit, check, payment, follow-up.
- Name the key resource at each stage: a trained, registered professional. Note what happens if it is missing.
- Write a one-page standard procedure per stage: who, what, tool, time, record.
- Choose three measures: speed, quality (errors per 100) and customer rating. Review them every week.
- Fix the cause of a defect, not the symptom. Ask 'why' five times and record the answer.
Worked example. Stage record: 'Prepare. Owner: lead. Time: 30 min. Tool: checklist. Record: signed sheet. Defect found on 1 of 55 visits last week; cause: missing check on a trained, registered professional; fix: add check at start, review next Friday.'
Second worked scenario. Scenario: of 220 visits last month, 13 had a defect traced to a trained, registered professional. Question: what is the defect rate and what is your first action? Model answer: about 6 defects per 100; stop the cause (add a check at the start), correct affected customers, log the cause, and re-measure next week.
Activity. Draw the process map and write procedures for the two riskiest stages. Run each once and time it.
Standard to meet. Write procedures a stranger can follow, record weekly numbers for each measure, and trace one defect to a root cause.
Module 5 Safety, quality and risk 4 hEvaluate
The most serious risk in this field is harm from a wrong or late decision. A calm, written risk routine protects people first and the business second.
- In health: Apply infection control: hand hygiene, cleaning logs, waste separation.
- List ten things that could go wrong. Score each for how likely (1 to 5) and how serious (1 to 5). Multiply and sort.
- For the top five, choose a control: remove the hazard, replace it, guard it, train people, or use protective gear, in that order of preference.
- Write who does what in an emergency, and rehearse it once a quarter.
- Keep an incident and near-miss log. Near-misses are free lessons.
- Check that insurance and legal duties match the risk you actually carry.
Worked example. Risk row: 'Hazard: harm from a wrong or late decision. Likelihood 3, severity 5, score 15. Control: written check before each visit, trained staff, log sheet. Owner: site lead. Review monthly.'
Second worked scenario. Scenario: a near-miss occurs: harm from a wrong or late decision nearly happened but no one was hurt. Question: what do you do in the next 24 hours? Model answer: make safe, record the event, ask the five whys, add or tighten one control, brief the team, and set a review date; near-misses count as lessons, not blame.
Activity. Build a ten-row risk register and a one-page emergency plan. Run a ten-minute drill with a peer and note two improvements.
Standard to meet. Rank controls by preference for the top risks, run the drill, and start the log. Where a regulation applies, follow the official rule.
Module 6 People, skills and service 4 hApply
People deliver the promise. Define roles, train to a standard and give feedback in the open.
- In health: Train all staff in basic life support and refresh yearly.
- Write a role card for each person: purpose, five tasks, the standard for each, and who to ask for help.
- Train by showing, doing with support, then doing alone with a check. Record sign-off per task.
- Set service rules for answering customers: reply times, tone, how to apologise and fix.
- Hold a ten-minute team check each day: yesterday's problem, today's plan, one risk.
- Build a growth path: what a new person can do in week 1, month 3 and month 12.
Worked example. Training record: 'Task: process a complaint. Shown 2 May; done with support 4 May; done alone 8 May, checked: apology, fix, follow-up call. Signed by lead.'
Second worked scenario. Scenario: a new hire completes training but a customer complaint shows a skipped step. Question: whose gap is it? Model answer: first the system: check the role card, the training sign-off and the checklist; then coach the person and fix the document so the step cannot be skipped.
Longer notes. Build the timetable from the length of a visit, not from the opening hours. Record for each clinician the slots booked, the visits attended and the minutes lost between patients. Train the reception team to check identity, confirm the next day's list and keep records closed when the screen is unattended. Write a cleaning and hand-washing routine between visits and check it each day. Plan cover for sick leave. Confirm each clinician's professional registration and the privacy rules for records before assigning any task. Review missed slots and waiting time every week with the whole team.
Extra worked example. To attend 220 visits with 12% of patients not coming, the clinic must book 250 slots. At 30 minutes each, that is 125,0 hours (visit length and booked hours per day are worked-example figures, not market data). A clinician with 22 days x 5 booked hours has 110 hours, so the clinic needs 1,14 clinicians. The 30 missed slots lose R$ 3.000 of contribution. Since 125 booked hours already exceed one clinician's 110, every slot lost to a no-show costs real capacity.
Activity. Write two role cards and a training plan for one new hire. Role-play a hard customer conversation twice and review.
Standard to meet. Write role cards with measurable standards, show the sign-off steps in training, and write the service rules in plain words.
Module 7 Money: cost, price and break-even 5 hAnalyse
A business lives or dies on a few numbers. Know your contribution per unit, your fixed costs and the volume you need.
- In health: Track no-show rate and average visit length; they decide how many visits fit a day.
- Contribution per visit = price minus variable cost. Fixed costs are paid whether you sell or not.
- Break-even units = fixed cost divided by contribution. Plan to pass it by a safe margin.
- Make a 12-month cash plan. Cash timing matters as much as profit: customers may pay late, suppliers may want money first.
- Keep money for business and money for the owner apart.
- Test the plan: what if sales fall by a quarter, or cost rises by a tenth?
Worked example. Worked example, all figures in reais: price R$ 180, variable cost R$ 80, contribution R$ 100 per visit. Fixed cost R$ 14.000 a month. Break-even = R$ 14.000 / R$ 100 = 140 visits a month. At 220 visits a month, profit = R$ 100 x 220 - R$ 14.000 = R$ 8.000. These are teaching figures that belong to this example only; later examples and the case study use their own figures. Use your own.
Second worked scenario. Scenario: sales fall to 165 visits a month. Question: what is the monthly result? Model answer: R$ 100 x 165 - R$ 14.000 = R$ 2.500; compare with break-even of 140 visits and decide whether to cut fixed cost or raise volume first. Teaching figures only.
Activity. Build your own table: price, variable cost, contribution, fixed cost, break-even and a downside case at 75% of sales. Show it to a peer or mentor.
Standard to meet. Calculate correctly, give every figure a source or mark it as an assumption, and show a downside case.
Module 8 Grow, measure and renew 4 hEvaluate
Growth should follow proof. Measure, learn, then add; and keep returning to the customer.
- In health: Grow through referral relationships with other registered professionals, never through miracle claims.
- Pick one growth lever at a time: new customers, a higher repeat rate, a better price, or a new offer.
- Set one measurable target for 90 days, such as 'raise repeat customers from 20% to 30%'.
- Ask each customer how they found you, and record it. Spend more where the record shows results.
- Review monthly: numbers, defects, complaints, cash. Write three decisions each time.
- Plan the renewal of licences, equipment and skills a year ahead.
Worked example. 90-day plan: 'Lever: repeat customers. Action: follow-up call after every visit. Target: repeat rate from 20% to 30%. Check: weekly count. Review date: day 45 and day 90.'
Second worked scenario. Scenario: you can add 44 visits a month by one of two levers: a follow-up call to past customers or a price rise of R$ 18 to R$ 198. Question: how do you choose? Model answer: test the cheaper reversible lever first (the call), measure for 30 days, and only then try the price change, so you can tell which one worked.
Longer notes. Grow by filling the timetable you already pay for. Count empty and missed slots by weekday and hour. Send a reminder the day before and again on the morning, and record how many patients confirm. Keep a waiting list so a freed slot is offered the same day. Ask each patient how they found the clinic and keep the answer in a table. Compare reminders by cost and effect. Avoid promises of treatment results, and keep every advert and reminder message inside the rules for health advertising and patient contact. Share each weekly result with the reception team and agree one action.
Extra worked example. The clinic books 250 slots a month and 12% are missed (worked-example rates, not market data), so 220 visits are attended. With reminders the missed share drops to 6%, giving 235 visits, which is 15 more. At R$ 100 each, that adds R$ 1.500 a month, or R$ 18.000 over a year. Those 15 recovered visits take the monthly result from R$ 8.000 to R$ 9.500 before any new patient is found.
Activity. Write a 90-day plan with one target, three actions and a review date. Present it in five minutes and take questions.
Standard to meet. Set a measurable, dated target, break the actions down small enough to start this week, and put the review date in the calendar.
