Direct Primary Care

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Dr. Paul Thomas Featured on the Soul of Enterprise Podcast

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This month, I was featured on the Soul of Enterprise Podcast and we had a great conversation around the Direct Primary Care Model and some of the challenges and opportunities therein. They also give a shoutout to the new Startup DPC platform, and how to start and grow your own Direct Primary Care practice. Here’s what they wrote:

WHAT HAPPENS WHEN A SMART DOCTOR RECOGNIZES THAT THERE IS A BETTER WAY?

Is it possible for family physician to operate under a subscription-based business model, priced below what you pay for your mobile phone service? What about services not covered by the subscription? Could those be priced with full certainty and transparency?

For episode 269, we had the pleasure of interviewing Dr. Paul Thomas, founder of Plum Health DPC. Dr. Paul Thomas is a board-certified family medicine physician practicing in Corktown, Detroit. His practice is Plum Health DPC, a Direct Primary Care service that is the first of its kind in Detroit and Wayne County. His mission is to deliver affordable, accessible health care services in Detroit and beyond. He has been featured on WDIV-TV Channel 4, WXYZ Channel 7, Crain's Detroit Business and CBS Radio. He has been a speaker at TEDxDetroit. He is a graduate of Wayne State University School of Medicine and now a Clinical Assistant Professor. Finally, he is an author of the book Direct Primary Care: The Cure for Our Broken Healthcare System.

Below are show notes and questions we asked our guest. Use these to help guide you along when listening to the podcast (embedded above).

Ed’s Questions

  • What is Direct Primary Care?

  • Based on an interview I saw you do, there’s no wait time for patients?

  • Why did you go this route—Direct Primary Care?

  • You were burned out in your residency. What was the moment that you said I can’t do what most people are signing up to do?

  • Most time patients do get with their doctors is spent with the doctor typing and facing a screen.

  • What are some of things that are covered in your clinic?

  • What you are capable of doing in your practice is probably 80-90% of what a healthy patient would need in a given year?

  • It would cost me personally about $840 in your practice. If you’re so cheap, why is healthcare so expensive?

  • It’s said America pays more than the average OECD country, but there’s no price transparency in the system, which inflates those prices, correct?

  • What are some of the barriers you see that are still in the way of physicians getting into DPC and patients being able to access DPC?

  • When you did start, did you consider other pricing models? Yours is based on age, but did you consider, for example, response times, or different services you would include and exclude?

  • Do you have any jumpers, and by that I mean people who pay for a month and then leave, then come back six months later?

  • You’re now also offering rates to small businesses in your area?

  • And the companies pay your membership as part of the employees benefit package?

  • You believe that patients should also have a catastrophic health insurance plan?

  • We don’t expect our auto insurance to pay for gasoline but we do expect our health insurance to pay for a blood test. It’s absurd?

  • I was struck that in your TedX talk you used the phrase “living my truth,” take us through that, what does that phrase mean to you? 

Ron’s Questions

  • In your book, Direct Primary Care: The Cure for Our Broken Healthcare System, you cite a 2016 study performed by Medscape found 51% of physicians experience burnout. Burnout is defined as a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. You felt this in your residency. How long did it take you to work up to 500 patients?

  • How did you market your practice, was it social media, word-of-mouth, press. I know you did a Tedx talk.

  • I know DPC is in the same family of Concierge Medicine, which has the reputation of being just for the elite, which isn’t true. But the DPC prices are usually less than a mobile phone bill.

  • On the cover of your book there’s a picture of you trying to catch sand through your hands. Can you explain that analogy?

  • You talk about technology and how there’s too much borrowing from Henry Ford’s assembly line, treating customers like commodities rather than human interaction. It’s not very efficient to sit and listen to your patient read you poetry. It is, however, highly effective. Would you agree with that?

  • You also talk how the average of GP doctors have 2,400 patients. Do you think this DPC model will alleviate this GP doctor shortage?

  • You talk about the growth of urgent care centers in the US is a symptom of a failed primary care system.

  • Do you feel that people who are not licensed could do some of the work now being done by physicians? What’s your view of occupational licensing and how it folds into this model/

  • You mentioned to Ed that insurance companies try to get as many dollars passing through the hands. They don’t seem to like the concierge or DPC models, not because they compete with actuarial based insurance but because they compete with pre-paid medical care. Did Michigan pass a law that made it clear that DPC is not an insurance product?

  • Just seems to be like insurance companies would like to block this model. Is that a fair statement?

  • There’s obviously some education going on with doctors with respect to DPC, but we also need to re-educate patients to see you even when they are healthy, not just when they are sick. Has that been an educational process to get patients to see you even when they don’t have an issue?

  • We talk a lot about the market share myth, that growth for the sake of the growth is the ideology of the cancer cell, not a sustainable, profitable business. You phrase it in your book as “Value over volume.” You must be asked a lot that healthcare is different than any other product or service we buy, how do you explain to people that it can be priced like other things we buy

  • Your model is restoring the sacred relationship between the patient and doctor. You’re bringing this back to the days of Marcus Welby.

  • I’ve read that most calls (82%) are received during normal business hours, that patients don’t abuse your time off. Has that been your experience unless there’s been an emergency?

  • Tell us about your new venture, www.startupdpc.com.

  • If you could wave a magic wand to reform healthcare, what would you do? [Price transparency and quality scores was Dr. Paul’s answer].

How To Listen to the Podcast:

How To get more Media Coverage for your direct primary care practice?

DPC Docs often wonder how they can get more media attention and more media coverage! Media coverage is crucial because it can amplify your message by one thousand fold. To be honest, this can be a tough process, as virtually every business wants to be featured in the media. But there are several steps that you can take to be featured in a big news outlet.

One of the first steps that you can take is to become Media Ready. What do I mean by Media Ready? You have to be ready to speak eloquently on air and therefore you have to practice. A great way to practice is by being interviewed on a local podcast. Speaking to reporters, being interviewed, and interacting with journalists is a skill that can be honed, and you can build that skill by working with podcasters. The more touches that you get, the better you'll become.

Action step: reach out to a local podcaster and ask if they'd be willing to feature you on their show. Repeat weekly until you sound amazing. Sometimes they will reach out to you, but more often you’ll have to reach out to them. Ask if they’d be interested in talking with you on their podcast. If so, great! If not, move on to the next opportunity.

Then, when a big media or show Program Producer is looking for a guest, they can listen to your previous material and decide if you'll be a good fit.

I’ve included our latest podcast interview (above) to illustrate that every podcast is a great opportunity - every interview helps me to be better and better, and every interview is an opportunity to reach the next customer, so I make time for as many interviews as possible.

Thanks for reading and listening! And, if you like this content, you’ll probably enjoy our course on Building a Sales Funnel. This course walks you through how to get more eyeballs to your website and therefore how to get more people to sign up for your Direct Primary Care practice.

Thanks again,

-Dr. Paul Thomas with Startup DPC

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The StartUpDPC Show Episode 3: Neil Batlivala of Sling Health

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Hiring a Medical Assistant versus Using a Digital Assistant in your Direct Primary Care Practice

There is definitely a tension point in many Direct Primary Care practices around how you, the doctor, allocates your time. How much time should you be spending doing paperwork and busy work? How much time should you be spending seeing patients? How much time are you spending growing the business.

These are tough questions that are difficult to answer - really there is no perfect answer. But, I would advise you to spend more time working on your business, and less time working in your business. This means that you should be directing the work of others, rather than doing all of the little tasks yourself.

When to Hire a Medical Assistant in your Direct primary Care Practice?

One of my mistakes in starting and growing a Direct Primary Care practice was not hiring a Medical Assistant sooner. A great medical assistant can create a warm and welcoming environment for your practice, give great customer service for your patients, and help you with the little tasks around the office like adding medications to the inventory or putting vital signs into the chart.

When you have a great Medical Assistant, they can build rapport with your patients and help with retention. For example, our Medical Assistant at Plum Health is Chris. He is excellent at drawing blood and giving flu shots, among other things. One of our patients bruises easily, and she said, “I always get a bruise when I have my blood drawn.” Chris responded “not this time.

A bet was made, and a plate of cookies was on the line. Chris drew the blood and our patient didn’t bruise, so delivered a delicious plate of White Chocolate Macadamia Nut Cookies, Chris’ favorite kind.

2019 Chris Lake Medical Assistant at Plum Health DPC.jpeg

How do you find a great Medical Assistant for your Direct Primary Care practice?

So how do you find a great Medical Assistant? I found Chris while working at an Urgent Care center. Chris was the best MA that I had ever worked with. I told him that when we were working together, and he told me that the feelings were mutual. When I left the Urgent Care, I wrote thank you notes to each of the staff members that I enjoyed working with, especially Chris.

Anyways, I knew that I would one day want to hire Chris or someone like Chris, so when that day came, I made the phone call. Chris answered and said that of course he’d love to work at my practice. Most Doctors have been in a similar situation – they have worked with a trusted and well-respected Nurse or Medical Assistant and they hire this person when they start their DPC practice.

A lesson here: always be kind to everyone that you work with. Your fellow Physicians, Nursing staff, and Medical Assistants may one day work with you, and they will definitely refer patients to you if they admire and respect your work. Make it easy for them to be excited about your practice by being kind to them through every interaction.

Our Conversation with Neil Batlivala of Sling Health

An alternative to hiring a personal Medical Assistant would be to use a tech-enabled solution like Sling Health. From their website:

Sling Health modernizes primary care with tech-enabled clinical support teams. Our software enables our remote team of care coordinators to provide high-touch care to patients, helping them better understand their care plan, navigate the complex healthcare system, and achieve their health goals. Our solutions reduce healthcare costs, improve health outcomes, and empower patients to be active participants in their healthcare plans. Based in San Francisco and founded by experienced healthcare technologists and clinicians, Sling Health aims to empower both patients and clinicians to rethink healthcare access and navigation.

There are a few DPC Doctors who have found this solution helpful, but I do not have any personal experience with this platform. Their pricing structure has recently changed from $5 per patient per month to a more tailored, à la carte payment structure.

Of note, a living wage for a medical assistant is roughly $2,500 to $3,000 monthly, depending on your community. Further, this person that you hire can create a warm environment for your patients and they can advocate for your practice.

Here’s our full conversation:

The StartUpDPC Show Episode 2: Dr. Shane Purcell on Working with Employer Groups and an AAFP FMX Recap

The StartUpDPC Show Episode 2

This is Episode 2 of the StartUpDPC Show, this time Dr. Paul Thomas interviews Dr. Shane Purcell of Direct Access MD in Anderson South Carolina. Check out his website, here: https://www.directaccess.md/. Here’s the full episode and read the discussion below!

Deciding to go DPC

Dr. Shane had been practicing for 17 years prior to starting his Direct Primary Care Practice, mostly as an urgent care doctor. But he noticed that many patients were having more and more chronic issues that he wanted to address. However, he lacked the technology resources to start a DPC practice, namely the automated monthly billing option.

He was actually considering a Micropractice option. However, he read more about DPC via journals like Medical Economics and the AAFP Journal, and once the technology component became available, he jumped in on the DPC movement. By leveraging technology like a cell phone and texting, he’s been able to be successful in streamlining his workflow and taking care of patients more efficiently. 

Working with Employer Groups

Doc Shane left the urgent care work 3 years ago, and slowly built up 300 patients and then shifted towards working with larger employer groups. Doc Shane has been on the speaking circuit about engaging with larger employers, and you can catch his talk via the Hint Health website, here: https://video.hint.com/magic-pixie-dust-and-miracles-dpc 

He’s been steady around the 600 mark for his patient panel, and he’s in a relatively small city with 25,000 people in Anderson South Carolina, and 200,000 people in the County. As a nerd, I looked up these stats – there are 27,293 people in Anderson, SC as of 2017 and 198,759 people in the County of Anderson, SC as of 2017.

All of this is to say that you can be successful with a DPC practice in small towns with relatively low levels of population.  Doc Shane says, “People need help everywhere, so even in small towns, DPC is very attractive for a lot of people. And, more and more employers are asking for it and looking for it and looking for ways to save money.”

Doc Shane is also trying to get some good data around taking care of large employer groups and how this translates to cost savings for the companies or larger entities involved. In my opinion, this is really important for growing the movement – proving the efficacy of DPC as a cost-saver for larger companies all while giving a better primary care experience for employees.

Doc Shane and Paul Thomas, MD catch a ride together at the AAFP DPC Summit.

Doc Shane and Paul Thomas, MD catch a ride together at the AAFP DPC Summit.

How many patients do you see as a DPC doctor vs as a Fee-for-Service Doctor?

Comparing and contrasting patient volumes, Doc Shane would see 30 to 40 urgent care patients in a day while he was practicing in that model in 2014. Now, in 2019, he’s seeing about 5 or 6 patients a day even with a full panel. But, he notes he does a lot of emailing and texting each day.

For me, I have a full panel of 500 patients and I estimate that I engage in 20 text message conversations and 5 to 10 email conversations daily. Doc Shane agrees with this, and estimates around 20 to 30 technology conversations each day. There are some fluctuations in terms of the days – Mondays and Fridays can be busier than the middle of the week.

On Partnerships in Direct Primary Care and on Hiring Doctors in DPC Practices

Doc Shane is a 50/50 partner with another Family Physician. He also employs two other physicians, and he pays them a certain percentage of their revenue. He and his team take care of collecting the revenue, social media, advertising, or reaching out to employers. We discuss how this allows the employed physicians to work 9 am to 5 pm, take care of their patients and enjoy a good balance between work commitments and home commitments.

One of Doc Shane’s employed physicians brought 300 patients or members with him when he joined the practice. He quickly filled his practice, and got up to 500 members. He works with an assistant and is able to earn just under what he made in the Fee-for-Service system, but with only 500 patients and only working 4 days each week.

I estimate that when you convert your Fee-for-Service practice to a DPC practice, and you have a long-standing relationship with your patients, you can anticipate 10 to 20% of your patients making the transition with you to DPC. Doc Shane agrees and adds that this depends on the time frame. We agree that Kissi Blackwell and Amanda Pennington have had rapid growth and high conversions.

Of your existing patients, it can be very hard to judge who will follow you to DPC. Doc Shane adds that some of those patients who don’t initially make the leap to DPC may reconsider 6 months down the line once they have a bad experience in the Fee-for-Service world without you as their doctor.

AAFP FMX 2019 Recap

Doc Shane is a leader in the Direct Primary Care movement, and also a rebel at heart.

Doc Shane is a leader in the Direct Primary Care movement, and also a rebel at heart.

AAFP FMX is perhaps the largest gathering of Family Physicians in the country, with about 5,000 to 6,000 Family Physicians as attendees. If you need live CME, this is a good conference because there’s an opportunity to get 30 or so CME credits. Doc Shane gives high praise to Julie Gunther’s “Trojan Horse” DPC talk aka the Joy in Medicine. However, if you’re focused on learning about DPC, there are few opportunities to zone in on DPC content because the DPC content tends to get washed out by the large volume of other sessions – like lectures on practice management in the Fee-for-Service world and general medicine lectures like Diabetes, Hypertension, and COPD. 

However, there is an opportunity to have a little bit of the AAFP’s ear in terms of participating in the DPC MIG aka Direct Primary Care Member Interest Group. There’s also an opportunity to discuss bigger issues via the DPC MIG online, a forum for AAFP members.

Should Midlevel Providers be able to Start and Run Their Own DPC Practices?

We also discuss Mid Level Providers engaging in Direct Primary Care, like Nurse Practitioners and Physician Assistants starting DPC practices. Doc Shane says that this is more of a legal issue, and that if this practice is legal in your state “you’re kind of stuck.” Additionally, he says that the AAFP is unlikely to take a formal stance on this issue.

Ultimately, Doc Shane advises DPC Docs to do the best that they can do in terms of offering services to your patients and letting your work speak for itself. For me, I agree with this. As a Doctor practicing in the DPC model, you have more time to use all of your tools, to deliver an even higher level of care than you could in the FFS model. This ability to practice at the top of your license will set you apart from the typical doctor in the FFS system, the typical doctor in the urgent care setting, and any midlevel provider in any care setting.

Doc Shane then brings up the other market forces, like Walmart setting up care clinics, which are mostly staffed by Nurse Practitioners and Physician Assistants. These are $50 per visit.

To combat this, Doc Shane recommends that we keep generating positive stories about our work as DPC doctors, and focus on the provision of higher levels of care, preventing ER visits, and providing a high level of value for our patients.

How to be Successful in DPC 

Find a mentor and spend time with another doctor in your area. The DPC community has good support, and doctors are generally willing to help other, newer doctors to be successful in this model. Hopefully this collegiality and support will continue as the movement gets larger. Use the online resources and attend conferences. Also, get together with your local DPC doctors, try to meet up a few times each year.

Closing Thought from Doc Shane

“It’s not easy doing DPC, but it sure is a lot better than traditional; it’s not easy but nothing worth having and nothing worth enjoying is ever easy.” It’s fulfilling, it’s satisfying, you go home with a full heart, and you’re really helping people, so it makes a big difference.

Thanks for reading and let me know what we should talk about next!

-Dr. Paul Thomas with StartUpDPC

Dr. Paul Thomas at AAFP FMX 2019

Paul Thomas MD at the AAFP FMX 2019 in Philadelphia

Paul Thomas MD at the AAFP FMX 2019 in Philadelphia

This week, I’m at the AAFP’s FMX for the DPC Summit and it’s been a ton of fun - this is the largest gathering of Family Physicians and it’s been inspiring to be a part of the conference.

Further, it's been an honor to speak about Direct Primary Care and the growing movement of physicians across the United States who have adopted this practice model over the traditional fee-for-service system.

Today, I was able to speak to family doctors who are considering the Direct Primary Care practice model and they brought a ton of great questions and a ton of positivity to the conversation.

Tonight, we'll be at AIA Philadelphia for a DPC mixer and tomorrow, we'll be hosting a DPC Member Interest Group meeting as well as two panel discussions on Direct Primary Care.

Full schedule for the event is here.

Anyways, I always want these posts to be valuable for my readers - I’m trying to help everyone grow the best DPC practice that they can. So a lesson learned from this trip is to post about your travels to conferences on social media. This gives your patients an opportunity to root for you as you lean and grow in your DPC practice. I wrote a post on my personal Facebook and Instagram account about my trip, and I had a ton of people reacting, commenting, wishing me well, and otherwise supporting me in my journey. When you get people excited about what you’re doing and why you’re doing it, they can become your biggest cheerleaders, champions, and advocates.

Thanks for reading and have a great day, and if you’re in Philly, say ‘what’s up!’

- Dr. Paul

Dr. Paul gettin’ loose before the presentation. Photo cred: Shane Purcell

Dr. Paul gettin’ loose before the presentation. Photo cred: Shane Purcell

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The StartUpDPC Show Episode 1: How this Direct Primary Care Doctor Successfully Leveraged His Personal Brand

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Building a Personal Brand can help you build your Direct Primary Care practice. By having a trusted personal brand, more people will be willing to sign up with your Direct Primary Care service.

Paul Thomas, MD and Kendrick Johnson, DO talk about personal branding for Direct Primary Care doctors on the first episode of the StartUpDPC Show.

Paul Thomas, MD and Kendrick Johnson, DO talk about personal branding for Direct Primary Care doctors on the first episode of the StartUpDPC Show.

But, many of you reading this are unfamiliar with how to build a personal brand. So, I wanted to show an excellent example of how to get this done.

Dr. Kendrick Johnson is a Direct Primary Care doctor with Ark Family Health and he recently made an excellent post on LinkedIn, which helps build his personal brand. The post is titled “Why this Doctor Had to Escape the Healthcare System.” During the video, he tells a personal story, shows real emotion, and even vulnerability. He becomes a relatable person and builds trust with his audience.

Because of this, we thought he'd be a perfect first guest on our StartUpDPC Show, where we will be interviewing thought leaders in the Direct Primary Care field and asking them some tough questions.

In our conversation, we talk about building a Direct Primary Care Practice, leveraging Social Media to get this done, the importance of Google Reviews, sustainable growth rates for Direct Primary Care practices and more.

One of the things that really struck me is that Dr. Johnson used a relatively inexpensive technology, an older-generation iPhone, to shoot his LinkedIn video. Take this as a lesson: you don’t need to hire a camera crew or an agency to produce high-quality content. Instead, you need to look into the camera (on the back of your iPhone or other smartphone) and tell your story with authenticity.

Thanks for watching and have a great day,

- Dr. Paul Thomas with StartUpDPC

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Positive Reviews for our Presentation at the AAFP DPC Summit 2019

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In June 2019, I was invited to speak about personal branding at the AAFP DPC Summit 2019 in Chicago. It was an incredible event with hundreds of Direct Primary Care doctors from across the country sharing best practices with each other.

Dr. Paul Thomas speaks at the AAFP DPC Summit 2019. His talk is about using your personal brand to grow your Direct Primary Care practice.

Dr. Paul Thomas speaks at the AAFP DPC Summit 2019. His talk is about using your personal brand to grow your Direct Primary Care practice.

My presentation was entitled "Building a Personal Brand to Grow your DPC Practice" and I talked about the tools that you can use to attract and retain patients for your DPC practice. Basically, if you can build a strong personal brand, people in your community will trust you with their health care and want you to be their doctor.

For the Effectiveness of Faculty (ie. knowledge of subject, organization & clarity, effectiveness of teaching methods), I was rated as excellent by 90.8% of the attendees. The remaining 9.2% rated me as very good. I had no good, fair, or poor ratings.

I received so many positive reviews for the presentation that I gave and it was really validating for the amount of time, effort, and energy that I put into these events. Anyways, here are some of my favorite notes from my colleagues:

-Excellent speaker! This was very helpful, and he’s got a fantastic, enthusiastic delivery!

- Great success story with outside-the-box marketing.

- Really interesting presentation. Eye-opening and useful for more than my practice.

Thanks for reading and have a great day!

- Paul Thomas, MD

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How to Build Your Personal Brand for your Direct Primary Care Practice

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Building a Personal Brand can help you build your Direct Primary Care practice. By having a trusted personal brand, more people will be willing to sign up with your Direct Primary Care service.

But, many of you reading this are unfamiliar with how to build a personal brand. So, I wanted to show an excellent example of how to get this done.

Dr. Kendrick Johnson is a Direct Primary Care doctor with Ark Family Health and he recently made an excellent post on LinkedIn, which helps build his personal brand. The post is titled “Why this Doctor Had to Escape the Healthcare System.” During the video, he tells a personal story, shows real emotion, and even vulnerability. He becomes a relatable person and builds trust with his audience.

Video of Dr. Kendrick Johnson posted on LinkedIn - this is a great example of how you can build a strong personal brand that will help you attract new patients to your practice.

Video of Dr. Kendrick Johnson posted on LinkedIn - this is a great example of how you can build a strong personal brand that will help you attract new patients to your practice.

So, the first part of building a strong personal brand is building brand recognition. Brand recognition is exactly what it sounds like: the ability of a consumer to recognize one brand over other brands. In other words, it's the ability of consumers to identify your product by its attributes and design elements.

But, in this case, it’s you and your face, your body, your beliefs, and the stories you tell. And no, you do not need to have a perfect face, body, belief system, or stories, but you do have to share these elements (aka your personality) with your audience.

So, in the example above, Dr. Kendrick Johnson is introducing himself to his audience by telling a story about himself. He even tells a very touching and relatable story about his father.

Importantly, he Dr. Johnson uses a medium that many people use - LInkedIn, a very popular social media platform. This sort of professional discussion about the role of a physician in society plays really well on this medium. In fact, LinkedIn is probably the perfect medium for this video.

And, because Dr. Johnson delivers a strong message with a great medium, he has great results, and this is based on the engagement that this post has received - over 100 reactions and several comments with thousands of post views.

The third part of this formula is consistency. If Dr. Johnson can create unique, engaging, thoughtful content that demonstrates his trustworthiness and compassion on a regular basis, he’ll build a strong personal brand. If this is a one-off thing, Dr. Johnson’s efforts here won’t be as impactful.

Consistency is key. Consistently generating high-quality content helps you win on social media platforms.

Thanks for reading and stay tuned for more content and more informational blog posts and courses.

Sincerely

-Dr. Paul Thomas

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One Daily Habit to help you Market Your Direct Primary Care Practice

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If you want to market your direct primary care practice, the best thing to do is to document what you do on a daily basis with pictures and short videos. This is a daily habit that can be very powerful for the growth of your personal brand and your business brand.

This is really important because you build a relationship with your audience, and they get to know and trust you. By seeing you consistently speaking about our sharing about your business or yourself, your audience will slowly get to know who you are. They will create a clear and consistent image of who you are as a person and as a doctor, and what your business offers.

Also, this is absolutely free! It only takes a few minutes of your time to get a photo or a video of you in your office doing what you do on a daily basis. Have your assistant or a physician colleague in your office help you with this. Have them hold your camera or iPhone or smartphone between you and the light source (window) in your office and share what’s going on that day.

You will get so many offers from people trying to help you to market your practice. If you have a smart phone and 30 minutes each day, you can absolutely do this on your own. The more you practice, the better your content will become. The point being, people who offer to shoot a glitzy video for you will charge you $2,000 - $3,000 for the video. AND the end result will not be as powerful as consistently telling your story on your own terms.

If you shoot a video with your smartphone, you can upload the video file directly from your phone to your YouTube Channel in a matter of minutes. You can then copy that YouTube video link and paste it into a blog post (just as I’ve done here) and this creates a loop. If customers find your YouTube Channel, they also find your Blog, and if they find your Blog, they also find your YouTube channel.

Keep it short and simple - address one topic at a time! Do not overwhelm your audience with too much information. If you remove a toenail, share about that one thing. If you lowered the cost of medications, share about that one thing. If you try to do too much in this format, it will be distracting or disorienting for your audience.

Remember, you have the attention of your audience for about 7 seconds or so.

If you want to learn more about this, take our Sales Funnel course where I show you more tips and tricks to grow your audience and get more patients to enroll in your practice.

Thanks for watching and have a great day,

-Dr. Paul Thomas

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How to Consult with Specialists as a Direct Primary Care Doctor

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How to Consult with Specialists as a Direct Primary Care Doctor

This is a big one for folks taking the plunge into Direct Primary Care - how do you as a Direct Primary Care doctor consult with specialists? Because you’re not “in-network”, how do you get patients the care they need outside of your office?

There are a number of ways to go about this and I’ll tackle three of them in this blog below. This blog post was prompted by a community question:

Message: Dr. Thomas,
I am about to start a DPC clinic. I completed family medicine in 2005 and am tired of the headache and hurdles of traditional primary care. One of the biggest things holding me back is how to refer to specialist? In one of your videos--you mentioned using a specialist service(for difficult ekg reading, endocrinology..etc). What was the name of that service?
Also--how do you deal with preventive stuff---like colonoscopy? stress test--if needed?

Any help in this category is greatly appreciated.

I am glad you got away from the insurance companies. I own a medical and day spa and will incorporate the monthly fee to cover facial/massage on the months the members do not need medical care.

Thanks again,

Option #1: Use the time that you have

Because you’re a Direct Primary Care doctor, you now have more time to read up on diagnoses and more time to guide your patients through the care that they need. By leveraging the increased time that you have, you can take care of more problems in your office and therefore have to refer less often.

Option #2: Develop close relationships with specialists in your community

If you are able to develop close relationships with specialists in your community, especially the private and non-hospital-affiliated specialists in your town, you can discuss cash prices for your patients.

I try to keep in close contact with my physician colleagues, and that’s part of the reason why I attend Wayne State University School of Medicine alumni networking events. Many of the opportunities that you find to lower the cost of care for your pa…

I try to keep in close contact with my physician colleagues, and that’s part of the reason why I attend Wayne State University School of Medicine alumni networking events. Many of the opportunities that you find to lower the cost of care for your patients will come from your network.

For example, by working with a local gastroenterologist in our region that owns a free-standing endoscopy suite, we were able to get cash prices for Esophagogastroduodenoscopies and Colonoscopies. They are roughly $1,000 each, which pays $400 for the facility, $300 for the Gastroenterologist to perform the procedure, and $300 for the Anesthesiologist.

Another example is Cardiology. We worked with a local cardiologist to get pricing on common tests that we need for our patients. Specifically, the Echocardiogram is $199, an Exercise Stress Test is $99, and a Holter Monitor is $99. These are very reasonable prices and they help us make better decisions for our patients.

Additionally, you can request visit prices/appointment prices from the specialists in your community.

Option #3: Leverage an online or e-Consult platform

As a Direct Primary Care doctor, you have the option to consult with specialists via online or e-Consult platforms. The platform that I, and many DPC doctors, use is Rubicon. Rubicon allows you to write up a consult and include PDF files or image files - EKGs, skin lesion photos, pathology reports, lab tests - and send this information to the consultant/medical specialist of your choice. The Rubicon platform has over 100 specialists and sub-specialists from Cardiology (Electrophysiology, Pediatric, Heart Failure, Lipid Disorder) to Endocrinology, Plastic Surgery, Transgender Health, and Women’s Health. The spectrum of consultants is quite broad here and the responses are very often thoughtful and helpful.

This is a great service and I enjoy using it, but be aware that you are liable for any decisions that you make for your patients based on using this service. Finally, if malpractice litigation was brought against you or Rubicon for an outcome related to using this service, you would be responsible for not only your only legal costs, but the legal costs related to Rubicon’s involvement. Caveat Emptor, read the Indemnification clause from Rubicon’s Contract:

14.      INDEMNIFICATION; LIMITATION OF LIABILITY:

14.1.    General Indemnity: RMD and CUSTOMER will each indemnify, defend and hold harmless the other and its officers, directors, employees, agents and Specialists from and against any and all direct third party claims, costs or expenses (including reasonable out-of-pocket attorneys’ fees), and payment of damages awarded by a court of competent jurisdiction in a non-appealable final judgment or agreed to in settlement (“Claims”), resulting from the gross negligence or willful misconduct of the indemnifying party; provided, that the indemnified party promptly notifies the indemnifying party of the Claim, gives the indemnifying party sole control over the defense and settlement of the Claim, and reasonably assists the indemnifying party in the defense of the Claim at the indemnifying party’s expense, provided such settlement provides for a full release of all Claims against the indemnifying party and its affiliates. For clarity, CUSTOMER’s indemnification obligation will include indemnification for the gross negligence or willful misconduct of all of the Users and Drafters.

Yeesh.

Thanks for reading, thank you for the question, and let me know what topic you’d like me to tackle next!

-Dr. Paul Thomas with StartUpDPC

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How Personal Branding can help you grow your Direct Primary Care Practice

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Intro

Tonight, I went live with the Direct Primary Care Alliance and talked about how personal branding can grow your Direct Primary Care practice. This is a huge topic, and I tried to tackle as much as possible in under an hour!

Currently, I’m working on my second course on this subject, Personal Branding for Direct Primary Care Doctors. If you haven’t seen our first course on Building a Sales Funnel, check it out here.

Why it’s important to Build a Personal Brand as a Direct Primary Care Physician.

2019 Dr. Paul Thomas on Building a Personal Brand to grow your Direct Primary Care Practice.png

Why is it important to build a personal brand as a Direct Primary Care Physician? Simply, building a personal brand is a great way to attract new patients to your practice. People/your potential customers spend a lot of time on Facebook. Instagram, and LinkedIn and these can be places where you can show your authentic self, where you can demonstrate your caring and compassion, where you can develop genuine relationships with people through social media.

Building a personal brand is all about communicating your character to your community or to your target audience. You can share about your successes and failures, your hopes and dreams, what you believe in, and why you decided to start a Direct Primary Care practice.

When you do these things, when you share about yourself in an honest and transparent way, your story and your character will start to resonate with people in your audience. They will identify with you and start to trust you for the person that you are, the caring, compassionate, and authentic physician in their community.

When you are a primary care doctor, you’re asking people to trust you with their most important resources: their health. By communicating your character, your ethos, and your values through these social media platforms, you can start to build that foundation of trust.