The Startup DPC Show aims to educate doctors who are starting and growing their direct primary care practices. If you want to take a deeper dive into starting and growing your direct primary care practice, check out our courses where we walk you through different skills that you need to be successful in your DPC practice.
Our guest today is a second year family medicine resident physician at UMass in Boston, Dr. Rami Wehbi. Dr. Rami is smart and savvy when it comes to many things, and it's remarkable that he has 12,100 followers on his Instagram channel, @DrRami.DO.
Direct primary care is different from fee-for-service medicine in several ways, and one of the big ways is that doctors have to reach out to their patients directly to get them to sign up for their services.
Family Medicine Resident disheartened by the current state of primary care
Dr. Rami has always been motivated to have a private primary care practice. He wants to take care of his patients on his own terms. He then searched for private practices that were successful. He first found concierge medicine, and then he found direct primary care. He reached out to me a few years ago and we hit it off. Together, we recorded an awesome episode for his Beyond Medicine Podcast, which can be found here. Dr. Wehbi is smart and kind, and he knows how to build a great following, either via podcasting or through his social media channels.
Paul Thomas MD of Plum Health DPC and Rami Wehbi DO a second year resident at UMass Family Medicine Residency Program, talk about challenges and opportunities in the Direct Primary Care space.
Educating Doctors about the Direct Primary Care model and movement
A big part about what drives me as a person is my mission to educate other doctors about the direct primary care model and movement. Further, I want to help doctors create the best direct primary care practices that they can, and that’s a big reason for this Startup DPC website, courses, and content.
Family Medicine Resident inspired by the potential of the direct primary care model
For Dr. Wehbi, it’s inspiring for him to see our successful direct primary care practice and other successful DPC practices across the country. Dr. Wehbi wants to be able to deliver a higher quality of primary care services. The average primary care doctor has 2,400 patients in their panel and they often see 25, 30, or even 35 patients each day. That means that these fee-for-service or insurance-based doctors have to see 3 or 4 patients each hour. These quotas are often written into the doctor’s contract.
For Dr. Wehbi, it’s mind-boggling that doctors would be expected to see 35 patients each day.
For me, it’s mind-boggling that you’d be expected to see 35 patients in a day and expect people to get quality care. It just doesn’t make any sense.
In our direct primary care practice practice, we have 640 patients total as of this blog post and my panel has 460 patients. I usually see 1% to 2% of my panel each day, so around 4 to 10 patients each day. This allows me to have 30 minutes to 1 hour with each patient and to really develop those strong, trusting relationships that can lead to better health.
What happens when patients need to see a specialist in the Direct Primary Care model?
Because we have fewer patients, we have more time to dedicate to our patients. We have more time to think and care and demonstrate compassion. We also have more time to look things up and to read up on a new diagnosis or the updated management of an old diagnosis. Further, we can work with our local specialist colleagues and develop cash-pricing for their specialty services. Finally, we leverage an e-consult platform called Rubicon MD to get specialty consults done in a matter of 4 to 12 hours.
Why would i pay for a membership-based service when I already have Insurance?
Well, you can restructure your insurance coverage to make it a more of a catastrophic coverage plan, meaning that you pay a lower premium and carry a higher deductible. Then, you can pair that low-premium, high-deductible health insurance plan with a direct primary care plan. This could end up saving you money as those insurance premiums can be quite expensive, and you can get better health care services as you have a trusted doctor at your fingertips.
Direct primary care for employer groups
For employer groups who buy insurance through the current fee-for-service insurance-based system, there is a ton of money lost on the middle men, plan benefit designers, and insurance brokers. Direct primary care clinics offer a way to lower the cost of health care for employees and employers by removing these middle men and offering excellent care and service to employees. And, having best-in-class service for employees will be another benefit for large employers looking to attract and retain top talent.
DOES DIRECT PRIMARY CARE MAKE SENSE FOR A PATIENT WITH MULTIPLE CHRONIC MEDICAL CONDITIONS?
Yes, direct primary care is a great system for patients with multiple chronic medical problems. The idea here is that the direct primary care doctor will have more time to fully address all of these multiple medical problems and how they interact with each other. By spending more time with our patients, we definitely prevent several costly and stressful visits to the emergency department or urgent care center each year.
“The urgent care system is a symptom of a failed primary care system. If your doctor had enough time to see you when you cut your finger or had bronchitis, you wouldn’t even have to go to an urgent care.” - Dr. Paul Thomas
For example, we recently had a patient who cut their finger at 5:30 pm on a Monday evening. They called me and I came in to sew up the laceration right away.
This model of care allows you to take full ownership of your patients - you can take radical responsibility for your patients.
Where to Find an Excellent Direct Primary Care Doctor?
If you’re looking to find an excellent direct primary care doctor in your neighborhood, check out the Direct Primary Care Mapper, here. If you’re in Detroit or Southeast Michigan, don’t hesitate to reach out to our Plum Health DPC clinic here in Corktown.
How can you start your own direct primary care practice?
Many medical students, medical residents, and doctors are looking for the best way to start and grow their direct primary care practices. Fortunately, Startup DPC has begun compiling some of the best content available on this blog and in our courses.
The best place to start is to take our Direct Primary Care Business Plan course, available here. From there, you can learn how to attract new patients to your direct primary care practice and how to find the perfect location or build out the practice of your dreams.
Thanks for reading and watching, and best of luck in your direct primary care journey!
-Paul Thomas, MD