How Long Will it Take to Fill My Direct Primary Care Practice?

How Long Will it Take to Fill My Direct Primary Care Practice?

Recently, I was asked how long it will take to fill a direct primary care practice with patients. This is a difficult question to answer because it depends on so many variables. It depends on your qualities as a physician, your personal brand equity in your community, the effectiveness of your branding and marketing efforts for your new business, your price points, and the value of your service.

A Basic Scenario for Filling Your Direct Primary Care practice

Let’s start by setting a target. If your target patient panel is 600 patients for your direct primary care practice, and you have an average of 25 new members each month, with 0 attrition, it will take you 24 months to get full.

Now, let’s factor in an attrition rate of 5 per month, so a net growth of 20 patients per month. In this scenario, it will take you 30 months or 2.5 years to get full. This sounds realistic, but in my experience it may take even longer.

Advice from a Successful Direct Primary Care Doctor, Ryan Neuhofel

For example, I talked to one of my mentors about this, Dr. Ryan Neuhofel, and he told me “it will take you 1,000 patients to get to 600.” And this is probably closest to the truth. Let’s say you enroll 28 new members each month for 36 months.

At the end of that 3-year period or that 36-month period, you’ll have 1,008 patients. If your attrition rate is 11 patients each month, you’ll have lost 396 patients over that period of time. This will leave you with a full panel of 612 patients.

Statistics from the American Academy of Family Physicians on Filling your Direct Primary Care practice

I wanted to include some statistics from the America Academy of Family Physicians (AAFP) on this subject, even though the sample size was small. According to the AAFP, the average DPC panel size is 345 patients. The average target panel size is 596 patients.

Only 17 percent of DPC practices have achieved their ideal panel size. Of those that have achieved their ideal panel size, the average time to achieving a full panel was 20 months.

So basically, most direct primary care doctors go into this venture wanting to reach 600 patients. For whatever reason, only 17 percent of doctors achieve this ideal panel size, while most doctors are hovering around 350 patients. Now, this data may not be the best data because of a small sample size, or it may have interviewed more doctors who are still in the growth phase and fewer doctors who are full. Perhaps the fuller doctors were too busy to complete the survey?

Important Considerations when Filling Your Direct Primary Care Practice

However, I did want to pose two important questions:

First, knowing this information, would you change your starting price point? That is, if you were planning on charging $50 per month wanting to get to 600 members and ultimately $30,000 in revenue each month, would you consider charging $85 per month knowing that you’d likely have only 350 members in your practice?

Again, there is no perfect answer, but I wanted to leave this here for your consideration.

Second, knowing that only 17% of direct primary care doctors reach their full panel size, wouldn’t you want to have every advantage possible when planning, starting, and growing your direct primary care practice? This 17% success rate is why I’ve created the resources on this site - to help direct primary care doctors succeed in the Startup DPC process.

Direct Primary Care Book

This passage is taken from my forthcoming book that will be published later this month on Amazon. If you’d like to know about the book publication and when it’ll be available, simply leave your email address here:

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE PRACTICE?

If you enjoyed reading this blog post and if you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC

How to Earn Grant Money for Your Direct Primary Care Practice

Just about every day, I get a new question from a direct primary care doctor who wants to start and grow their own direct primary care practice. They’re looking to replicate the success that we’ve had with Plum Health DPC here in Detroit, Michigan. One of those questions is in regard to how we were able to earn grant money for our direct primary care practice. Here’s the question:

I saw you had mentioned getting a grant for your DPC practice and I wanted to find out how you were able to do that. I haven't been able to find much online. 

Thank you. 

- Aspiring Direct Primary Care Doctor

To date, we’ve earned $107,500 in grant money to start and grow our direct primary care practice, Plum Health DPC in Detroit Michigan. We’e earned this money by applying to specific programs that can help us succeed in this space.

The first program that we ever won was a pitch competition for $7,500. This pitch competition came at the end of a Retail Boot Camp experience at TechTown Detroit. Here’s the full blog post:

Over the past 9 weeks, I have participated in a class at TechTown Detroit called Retail Boot Camp. The RBC course is comprehensive in its approach to helping your business grow, from addressing your financial situation, to helping you choose a POS system, to refining your marketing and advertising strategies, and beyond. 

The best part of the RBC course was having a strong group of entrepreneurs to work with and learn from - people like Jay Rayford of Social Sushi, Nicole Mangis of Brut Detroit, Lionez Kimber of Artistic Flesh Tattoo and Supply, and 16 more phenomenal, bright small business people. I learned a lot from their successes and emulated their approaches to doing business in the city. 

The class culminated in the Retail Boot Camp Showcase, a mini pitch competition for the 20 students/small businesses who took part in the class. It was a great night that brought together teachers, mentors, supporters, consultants, family and friends. 

We were able to give our 90 second pitch on Plum Health DPC and then we were selected to give a follow-up 3 minute pitch about our plan to deliver affordable, accessible healthcare services in Detroit. It was well received and we were ultimately awarded a $7,500 grant from TechTown! 

The next grant we won came through the City of Detroit and their Motor City Match program for $50,000. For this program, we were looking at building out a larger office in Detroit, and we were trying to match with a vacant retail space in the City of Detroit. We applied three times to this grant program, and received the grant on the third try. The journey for this grant is detailed in this blog post:

This was a big week for Plum Health DPC - we received a grant from the Motor City Match Program! This brings us one step closer to delivering affordable, accessible healthcare services in Detroit.

Crain's Detroit Business wrote an article about the event, and here's what they said about Plum Health DPC: 

Plum Health Direct Primary Care, $50,000: This health care facility provides an alternative to the traditional fee-for-service model. Direct Primary Care emphasizes wellness, prevention, communication and personalized patient relationships. For a monthly fee, members receive primary health care services that are tailored to their needs. These might include annual checkups, urgent care services and direct and unrestricted access to their doctor through calling, texting, emailing or in-person visits. The business is planned for 607 Shelby St. in downtown Detroit.

Additionally, Local 4 News in Detroit (WDIV) wrote an article about and created a video of the Award ceremony. Here's what they said: "Six Detroit entrepreneurs are putting their small-business plans into action after the Motor City Match program awarded them thousands of dollars to get started. Mayor Mike Duggan made the announcement Friday morning."

An article from the Michigan Chronicle wrote about the award and quoted Mayor Duggan: 

“Quality restaurants, health and wellness providers, arts centers are exactly the types of establishments that people expect when they think of a strong community,” said Detroit Mayor Mike Duggan. “These Detroiters are proving that our neighborhoods are great places to start a business.”

This is another step in the journey toward bringing affordable, accessible healthcare services to Detroit and we will continue to work diligently to deliver these services. 

The last grant that we won was for another $50,000 via the Quicken Loans Demo Day. Again, this was a pitch competition and I applied to this pitch competition twice. The first time, I was rejected, and the second time, I was given the opportunity to pitch. Once on stage, I rocked it out, and we were awarded $50,000 to help us deliver affordable and accessible health care in Detroit and beyond. Here’s the full blog post detailing the event:

Last night, Plum Health DPC won the Detroit Demo Day 2018 prize for $50,000 in the "Start" category! This was an amazing experience from start to finish - the level of professionalism on the Demo Day team is unrivaled. 

It was an honor to even be selected for the pitch competition, but then to have a team of professionals help me hone the pitch, and a team of people create such an amazing event to showcase small businesses in Detroit was truly incredible. Thank you to these folks at Quicken and at the Music Hall!

I was blown away by the amount of people who came out to support entrepreneurship in Detroit, the Music Hall auditorium was packed with cheering family members, friends, business associates, investors and enthusiasts - this is truly a special moment in Detroit for entrepreneurs and small business owners. 

Additionally, I have so much love for all of the presenters and Detroit entrepreneurs who stood tall and pitched their unique businesses, whether or not they walked away with prize money. They are all worthy of your support as they've worked tirelessly to even get onto this stage - House of Pure Vin,  Michigan Farm to Freezer, Rebel Nell, Accelerate Kid, Building Hugger, Cynt-Sational Popcorn, Detroit Denim, Tait Design, The Ten Nail Bar, Bloomscape, Lush Yummies, Reilly Craft Creamery, Fangage, and Yum Village. 

Now that we've won, we plan on growing into a larger space, hiring another doctor, and serving more people in our community. This is just the beginning. 

Here's our winning pitch (time 1:11:23):

How to Earn Grant Money for your Direct Primary Care Practice

Here’s my general advice on earning grant money for your direct primary care practice:

1. Meet a need in your community.

2. Make your service affordable for the everyday people and the typical patients in your community.

3. Deliver an excellent service that helps people and that gives more value than the price paid for the service.

4. Find grant programs that support the type of work that you’re already doing.

5. Define the goal that you want to achieve and the gap that the grant money will help you transcend. The people who give out grant money want to see the money put to great use to solve a problem or address a major challenge. Show these people why you’re the right person to solve that problem or address that challenge.

6. Apply, apply, and apply again. Don’t be discouraged by rejections.

7. If the Grant involves a pitch competition, practice your pitch 100 times (I’m not exaggerating) until you know ever word, every inflection, every pause, and every emphasis in your pitch.

8. If the Grant involves a pitch competition, work with a professional to help you hone and improve your pitch so you can elevate your game. Even NBA All Stars have coaches, right?

9. Use the money to benefit your patients by making your service even bigger and better. We used our grant money to build out a larger office and hire a second doctor, which helped us to serve more patients and therefore attract new patients.

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE PRACTICE?

If you enjoyed reading this blog post and if you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC

Dr. Paul Thomas on Primary Care Cures with Ron Barshop

Recently I was interviewed by Ron Barshop on his podcast, Primary Care Cures. Here’s what he wrote about the show:

In this episode Ron gets the chance to chat again with Direct Primary Care expert, Dr. Paul Thomas of Plum Health DPC. In this episode he talks about how we went directly into primary care out of college and what his work week looks like, including blogging and youtubing the DPC message. He stressed the importance of relationships with small businesses and reaching the public via social media. Paul touches on how he has been successful in growing his business without brokers so far. He discusses what it takes start a DPC practice, the importance of a good name, creating a SEO course for DPC docs. He addresses Fears physicians have about going into DPC. Here Paul also shares his thoughts around end of life care and end of life care planning.

Paul is a board-certified family medicine physician practicing in Southwest 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.

Listen to the full interview here.

Here’s an excerpt from the interview (below) and the full transcript is here.

How I decided to start my direct primary care practice

Yeah. Well, in my last year of medical school, I actually heard Josh [inaudible 00:04:50] on a podcast and I kind of filed that idea in the back of my brain because I thought I was going to be a professor at a teaching hospital and seeing patients and working with the residents and students, but the deeper and deeper I got into my residency, the less and less time I had with my patients. And I found myself really unsatisfied in the level of care I was able to deliver to my patients simply because I didn't have enough time. Page 3 of 13 And then I got to see Clint Flanagan, Dr. Clint Flanagan of NextEra in Michigan. He was speaking in a conference in Michigan. And so, I talked to both of these physicians and I asked if I could visit their practices. And so in my last year of residency, I wrote a curriculum, a direct primary care curriculum, and I drove out to these two practices and I took the best of their ideas and I brought it back to my hometown in Detroit. And that's where I started Plum Health. And that's three years later from that moment, I'm full with 500 patients and I've brought on a second doctor to help me meet the additional demand.

What’s a Typical Day Like for a Direct Primary Care Doctor

Well, typically most busy on Mondays and Fridays and I'll typically see about five to eight patients each day. Typically, one hour for new patients and 30 minutes for followups. I'll do a lot of texting and phone calls with my patients. I typically field about 20 to 30 text messages each day and just answering some simple questions or coordinating appointments or texting my patients and asking them, "Hey, I saw you on Wednesday with a runny nose and cough. How are you feeling today now that it's four or five days later?" So, that's a workflow that I have and I'm typically in my office 9:00 AM to 5:00 PM.

The other part of it is like on a weekly basis, I'm working on blog posts. I write a blog post and shoot a short YouTube video and post that onto my blog. And then on a weekly basis, I reach out to a small business in my community and ask them, "Would you like to enroll your people into our membership model?" And so, there's different hats that I wear. I'm of course always checking the finances of the business and making sure that our profit and loss statement is lining up each month. So, there's other things beyond patient care and I just fit those between my patient visits so that my business remains healthy as well.

Paul Thomas interviewed by Ron Barshop on Primary Care Cures. See the original post, here.

How do you attract new patients to your Direct Primary Care Practice?

Yeah, I think it's important to develop relationships with small businesses because I really believe that if you're a small business and you're not offering some sort of health care benefit, you would be doing your employees a great service by offering something like this, even if you can't afford health insurance. This is something where offering like direct primary care can help employees maintain a good level of health and have something where they can actually access a physician and have guidance through their illnesses and injuries. And then, I'm also really focusing on social media and reaching the general public. That's where 90% of my members are coming from. So, I try to strike a balance of landing some larger groups, some larger customers, and also maintaining an outreach to individuals.

As for employer groups, I mostly am focusing on those employer groups that are fewer than 50 full time equivalent because those are the folks that aren't mandated to provide health insurance for their employees and they often end up in this messy middle where they're not doing anything because they don't know what's out there.

How Do I Start a Direct Primary Care Practice?

Well, I actually get this question so much that I decided to put all of my knowledge into a website that I recently created and it's in a soft launch right now. It's called startupdpc.com. And folks can go through and read how to, how to start a direct primary care practice. There's a long form blog post that I put there where you can read through, okay, do I have the right mentality to start this? Am I willing to give up the paycheck? Do how to come up with a great name for my practice? How to develop a website? How to build out social media channels? And that kind of gives you a broad overview of if this is something that you want to tackle on your own or with a partner or with some help. And then, I take it one step further and I take a really deep dive into individual topics. And I put together some courses that people can take to really cement their knowledge and become proficient in the skills that you need to become a great direct primary care physician with a thriving successful practice.

A lot of people in medicine have no business experience. And one of the things I often tell people is business is relationships. So as a primary care doctor, we are the most friendly, outgoing doctors that there are. And so how do you cultivate good relationships with people in your community, with small business owners, to create a practice that works for you and works well for your patients?

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE Practice?

If you enjoyed reading this blog post and if you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC

What Questions Should I Ask My Accountant When I Start a Direct Primary Care Practice?

This is a big questions that a lot of soon-to-be direct primary care doctors have - what should I be getting out of my accountant or what questions should I be asking of my accountant when I start my direct primary care practice?

What Should I ask my accountant before I start my Direct Primary Care Practice?

First of all, congrats on starting your direct primary care practice! When you first meet with your accountant, make sure that you trust them and make sure that they’ve worked with similar businesses in the past. There’s nothing worse than an accountant that sees you as a dollar sign.

Next, you can find out what your accountant prefers in terms of everyday tools that you’ll need to be successful. For example, you could ask your accountant how they intend to manage your profit and loss sheets. You can also ask them how to manage your payroll services. You can also ask your accountant if they’ve had experience in helping doctors get funding for their direct primary care practices. All of these will help you pick an excellent accountant.

What is an Employer Identification Number (EIN) and why do I need one for my Direct Primary Care practice?

Before you meet with your accountant, you should probably register your business with your State so that you can get an EIN. According to Wikipedia: “The Employer Identification Number (EIN), also known as the Federal Employer Identification Number (FEIN) or the Federal Tax Identification Number, is a unique nine-digit number assigned by the Internal Revenue Service (IRS) to business entities operating in the United States for the purposes of identification.”

The EIN is important for you because you’ll need this number to set up a bank account for your business. Once you have a business bank account, you can transfer money into this account and then start making purchases through your business bank account. This will help you to build credit in your business and help you to become eligible for a loan in the future.

Which Accounting Software Should I Use for my Direct Primary Care practice?

When you meet with your accountant, you should definitely discuss accounting software. There are a few options out there in the marketplace, but I currently use and enjoy using Quickbooks by Intuit. Quickbooks is about $70 monthly and it shows you how much money you’re bringing in or your profit and how much money your spending on your business or your losses. These two elements and the charges therein comprise your profit and loss statement.

Personally, I check my profit and loss (P&L) statement everyday as it gives me a good idea on how well our business is performing. Every quarter, I review my P&L with my accountant and we discuss what’s going well and reconcile any ambiguous, erroneous, or duplicate charges.

If you don’t know your numbers and you give complete control of your profit and loss statement to your accountant, it will be hard for you to keep your finger on the pulse of your business. That’s why I recommend discussing these things up front when you first meet up.

Do I need a Payroll Company if I’m the Only Employee?

Usually you don’t need a payroll company if you’re the only employee in your direct primary care practice. Once you hire another doctor or a medical assistant, you’ll need to set up an account with a payroll company so that they can help you keep track of payroll taxes. If you’re a solo doc and if you have an accounting software like Quickbooks, you can pay yourself through an owner’s draw. This is a simple way of paying yourself when you’re just starting out.

Other things to discuss with your accountant when starting a Direct Primary Care practice

There are so many other things you can discuss with your accountant when starting your direct primary care practice. Here’s a few other topics to broach:

• How long have they been an accountant?

• How long do they plan on continuing to practice accounting?

• What kind of lending options or practice finance options they’re familiar with for medical startups?

• Which payroll do they frequently work with and what are the pros and cons of using that payroll service?

Some banks have a strong practice finance division that could help fund your startup and find out if your accountant has worked with these banks in the past and understands the processes involved.

Find out which payroll company your accountant recommends and then compare that one to others like Gusto or Paychex to make sure you're getting a good/honest deal.

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE Practice?

If you enjoyed reading this blog post and if you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC

Startup DPC Mailbag: Should I Hire a Second Doctor for My Direct Primary Care Practice?

This week, I received an insightful email from a medical student who’s interested in starting and growing a direct primary care practice of her own. This is super exciting - I love hearing about medical students who are looking to create fulfilling, successful independent practices. Here’s the first part of the note I received from this eager student, followed by their further questions:

So, I have a finance and small business administration background, so I'm really interested in the nuts and bolts of how things are working or not working for direct primary care doctors like yourself right now.  I have a few questions for you:

What works well financially for a direct primary care practice?

What is working well financially for you right now?

Our direct primary care practice is working well for us financially at this time. We currently have 680 or more patients between two doctors. Because of our membership model, we have a guaranteed revenue stream from our patients as long as we continue to give excellent service to our patients.

I think we set our prices just right at the outset of starting our practice because we have roughly 30 new members enrolling in our service each month. That tells me that it’s not too cheap so that a deluge of people are enrolling, but it’s not so expensive that the cost of the membership is prohibitive for people looking for this type of service. Rather, we’ve hit a sweet spot in the marketplace where we’re financially successful at a relatively low price point.

We’ve kept our overhead low and supplemented our clinic revenue with Botox services and Osteopathic Manual Therapy services. I also earn revenue from consulting with doctors who are starting and growing their direct primary care practices and through course sales via this website. These earnings are modest relative to the revenue earned through my clinic, but it’s worth mentioning.

Should Your Direct Primary Care Practice Have a Scaled Membership Fee Structure?

Is the scaled membership fee you have working well for you?  

At our practice in Detroit, Plum Health DPC, we have relatively low price points. Our membership is $10 each month for children and starts at $49 each month for young adults. Keep in mind that Detroit has an average household income of around $26,249, so our price points are intentionally low to accommodate all members of our community. Even with relatively low membership price points, we are able to earn a comfortable living by keeping our overhead low and by being judicious with our collections.

At our Plum Health DPC clinic in Detroit, we have relatively low price points that respect the relatively low incomes of our neighbors. The median household income in Detroit is roughly $26,249. Despite these low prices, we are able to make a comfortable living with our direct primary care practice and we’re able to pay our medical assistant a living wage.

The scaled membership works really well because it right-sizes the cost of primary care services for our individual members. For a single mom, $69 each month fits for her and her two children under the age of 18. For the 30 year old restaurant worker without any other form of insurance, the $49 monthly fits for his budget and lifestyle. For the 50 year old truck driver with high blood pressure and hypothyroidism, the $69 monthly as well as the convenient access for appointments when “just passing through” makes the service very valuable for him.

And this is super important and something that doctors can lose sight of when starting and growing their direct primary care practices: you must provide a tremendous amount of value to your patients in order to have a successful direct primary care practice. If you don’t provide a lot of value for your patients’ healthcare dollars, you will struggle in this venture.

Notably, to be viable in a direct primary care practice, your collection rate should be at or above 90%, meaning that you need to collect 90% or more of all of your charges. If you fall below this threshold, it becomes much harder to build a sustainable practice. I mention this here because if you’re providing a valuable and useful service, your patients are more likely to engage with your services, use your offerings, and pay for your membership.

What Would You Have Done Differently in Starting and Growing Your Direct Primary Care Practice?

Now that you're a few years in, what would you have done differently at the outset?  

I met with another provider here in Richmond who keeps a pharmacy for her patients.  She says it's a TON of work, but she wants to do it (for now).  She also mentioned that she was a little TOO available at the outset and she wishes she hadn't done that.)

I have very few regrets about how I’ve started and grown my direct primary care practice. I started my journey by taking small business courses, which were tremendously helpful in helping me transition from Residency to a Small Business owner. I graduated from Residency in June 2016 and took those small biz classes from July through November of 2016. I took two separate classes that ran pretty much consecutively.

I won $7,500 in grant money from the second small business course and I launched my practice in November 2016 with about 7 patients. It took me about 2.5 years to get full, and then I was able to hire a medical assistant and a second doctor. Hiring a second doctor allowed me to grow in so many different ways, and I’ve also gained a trusted colleague and a great friend.

Next, I’ve been able to build a dream practice for myself in a historic location in Detroit’s Corktown neighborhood. Our practice sits on the former site of the Tiger Stadium, where baseball greats played, like Babe Ruth and Ty Cobb.

Looking back over the past three and a half years, I’ve worked really hard to create a thriving business, and I wouldn’t really change anything. I love dispensing meds out of our office because I love saving my neighbors loads of money on the costs of the prescriptions.

I love being available to our patients because I’ve saved countless members thousands of dollars each by preventing unnecessary Emergency Department visits. Here’s one ER visit we saved by sewing up a dog bite on a Sunday night:

View this post on Instagram

Another week another laceration repair. This time it was Sunday evening at 6:20 pm when I got the text 📲 Our guy got bit by a dog 🐕 and a few stitches 🧵 would be needed. I met him up at the office at 7:10 pm and gently placed 3 sutures. Usually you leave dog bite wounds open, but the Infectious Diseases Society of American (IDSA) recommends closing facial lacerations because it is cosmetically important and has a lower rate of infection relative to other areas, perhaps due to better blood supply. It took about 1 hour of my time in total, but saved my patient a few thousand dollars 💵 by preventing an ER 🚨 visit. Also, we stock the Augmentin antibiotic that he needed, which only cost him $8. In this #directprimarycare model, our patients get the care and attention they need, when they need it at an affordable cost. Our healthcare system is better off too, because now the ER doc can focus more time and attention on the patients who are coming in with heart attacks and strokes. #winwinwin #somuchwinning #fixinghealthcare #familymedicine #primarycare

A post shared by Paul Thomas MD (@plumhealthdpc) on Feb 18, 2020 at 3:58pm PST

How much money do you need to start a Direct primary Care practice?

Do you have any long term liabilities related to start up? Everything I hear says you probably want around 10-20k to startup, which sounds about right - how did you navigate the startup process and what were your best resources?

I wrote an entire blog post on this one question, here’s the full blog post on how much money you need to start a direct primary care practice and here’s an excerpt from that blog post:

This is a question I recently received from someone interested in the direct primary care movement. And, it's a good question. I'll start by saying that I've addressed this question in great detail in my course on Writing a Business Plan for your Direct Primary Care practice.

So, for a full answer to this question, please go to our Take Action page and check out the Business Plan course!

To answer the question more directly, a direct primary care practice can be started with $5,000 or with $50,000. It depends on how expensive your lease is, how many staff members you have, how much equipment you need to buy, and how resourceful you are.

For many doctors in the direct primary care movement, they know how important it is to keep their overhead low. A lower overhead leads to a lower price point for patients and therefore a more sustainable medical practice.

For me, I launched my practice with about $20,000 in the bank. I bought a $700 exam table, a $1,700 EKG machine, and a $700 pulmonary function test (PFT) machine. I spent about $600 each month on rent, $450 each month on my malpractice insurance, $300 monthly on the electronic medical record system, $500 monthly on medications, and $500 monthly on lab work. Those were the biggest expenses when I started, and my monthly expenses for the first few months of practice were in the $3,000 monthly range.

This low overhead made it easy to break even for operations, and I broke even for operations with around 85 patients or 85 members in my practice.

Looping back to your initial inquiry, I navigated the startup process by taking some small business courses from some excellent sources here in Detroit. One was via the Build Institute and another was through TechTown’s Retail Boot Camp. They were each 8 weeks long and walked me through forming a business entity, branding, marketing, public relations, raising money for your business, acquiring customers, creating a customer avatar, networking, negotiating lease documents, and building out retail spaces. These courses presented a ton of information over 16 weeks in total, and it was a huge time investment on my part, but it paid off as I was able to create a thriving business based off of these teachings.

I know not everyone has the time and the capacity to take in-person classes, so I’ve distilled much of what I’ve learned from those courses into these courses on our website and I’ve streamlined the material to focus on what doctors need to know. I really tried to focus time, energy, and attention in the courses to those natural blind spots that physicians have when starting a business.

I highly recommend taking these courses because they will accelerate your growth and help you skip over many mistakes and pitfalls along the way, which could in turn save you thousands, if not tens of thousands of dollars.

Should I hire a second doctor for my Direct primary care practice?

Last one: I see you have a partner in your practice!  Do you find this has been financially advantageous for you practice compared to a solo practice?  

There are so many tangible and intangible benefits to hiring a second doctor in your direct primary care practice. I mentioned this above, but by hiring a great physician in my practice, I’ve gained a trusted colleague and a great friend.

Direct primary care doctors often ask if they should hire a second doctor for their direct primary care practices and how to hire a second doctor for their DPC practices. I answer the first of these questions in this blog post. Above, Dr. Paul Thomas MD and Dr. Raquel Orlich DO of Plum Health DPC pose at their office in Detroit, Michigan.

Having a second doctor allows me to have someone to share an interesting case with, who can help me manage my patients better by teaching me things along the way. A second doctor also allows me to take a vacation in a relatively care-free way - I don’t have to close my clinic or not be available for my patients because the second doctor can absorb those urgent concerns in my absence.

For me, I didn’t hire a second doctor to make more money, but I did hire a second doctor to build a more sustainable practice. Eventually, as my colleague fills their panel with more patients, I will earn more money, but this was never a top priority.

My top priority has always been delivering excellent care and service to the people in my community, and my practice partner joined my practice to help me achieve this goal. And, that’s why we’re successful.

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE Practice?

If you enjoyed reading this blog post and if you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC

Startup DPC Show Episode 9: This Primary Care Doctor Charges $35 Per Visit

This week, I get to talk with Dr. Timothy Wong of iHealth in Pittsburgh, Pennsylvania. Dr. Wong is obviously a smart physician and he’s also a smart business person. To be successful in the Direct Primary Care model, it helps to be great at what you’re trained in, medicine, and it’s essential to learn new skills that will help you succeed in creating a thriving business as well.

I really enjoyed my conversation with Dr. Wong because this Episode of the Startup DPC show is full of excellent advice and great tips to help you start and grow your Direct Primary Care practice.

What is the Direct Access Primary Care model?

The Direct Access Primary Care (DAPC) model is something that Dr. Wong has built upon. He states that it’s similar to direct primary care, but the DAPC model is not membership based. Instead, patients pay $35 per visit, plus additional costs depending on which types of services they require. In Dr. Wong’s DAPC model, he doesn’t bill or use insurance for the visits and he keeps a very low overhead. He leverages technology like his EMR as well as Google Forms to collect vital information on his patients quickly and efficiently.

How Did You Market Your Direct Primary Care Practice?

Personal Branding, Business Branding, Marketing, and Public Relations can be foreign topics for a lot of physicians. This was also the case for Dr. Wong as he didn’t have any formal training in these areas. However, that did not stop him from taking a tremendous step towards making his name known in the community and beyond his community.

I reached out to Dr. Wong for this episode because I saw his profile on LinkedIn and I recognized him from the recent NPR article about his practice. He had this to say about his experience in engaging with the local media, also known as public relations:

“Media kind of snowballs. Once you get one thing, a lot of reporters are actually looking for stories - we don’t realize that, but they’re actually looking for stories. And, if you have an interesting story, they’re going to reach out to you. But, you have to get that initial momentum going”

So how do you get that momentum going? Dr. Wong recommends cold emailing journalists and talking up his practice. He was first interviewed by a local newspaper, and then it snowballed into the local NPR affiliate, and then NPR and other national media outlets.

As long as you have an interesting story that could touch a lot of people and help a lot of people, the story starts to speak for itself.

In journalist parlance, that “interesting story”is also known as a peg, or the reason for writing the story in the first place. As Direct Primary Care doctors starting new clinics and hiring new doctors, we have a very clear peg.

The Importance of Sending the Email

Dr. Timothy Wong talks about sending dozens of emails to journalists, but only getting one story. But the difference between no stories and that one store (that may start a snowball of additional stories) is tremendous. If you have no stories, you have a limited stream of new customers. If you have just one story, that then snowballs into additional stories, you may open a floodgate of new patients, new enrollments, and new customers for your business.

That’s why it’s important to send the email, to reach out to the journalist, to tell your story so that your clinic is featured. You’re doing great work that’s changing lives and changing the community, and the world needs to know about it! So, send the damn email.

Business Logistics at iHealth in Pittsburgh

Timothy Wong MD of iHealth in Pittsburgh Pennsylvania talks with Dr. Paul Thomas of Startup DPC about how he’s starting and growing his direct primary care practice.

Dr. Wong uses Athena Health for his electronic medical record. He pays a percentage of his revenue to AthenaHealth, about 6.4% of revenue, but that includes all merchant fees on credit cards. He uses Google Forms to collect patient information up front for his new patients. This helps him prep charts quickly and efficiently.

As for growth, Dr. Wong would like to get up to 20 to 30 patients each day, or a higher volume for his practice. He’s enjoying the practice and feels less burned out. His patients enjoy the service, especially those uninsured patients in his community and those with high out-of-pocket costs. He’s also looking at how he could grow his practice, either by franchising or consulting or by creating an open source platform that other people can replicate.

Dr. Wong is also looking at creating an application that can be a plug and play option for doctors looking to start this Direct Access Primary Care model.

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE Practice?

If you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC

Should I start a direct primary care practice during this recession?

This is Dr. Paul Thomas with Startup DPC - I help doctors start and grow their direct primary care practices. A common question that I have been getting lately is in regards to if it’s a good idea to start a direct primary care practice right now because of the coronavirus and the effect on our economy.

Should I start my Direct Primary Care Practice During a Recession?

The first thing that I’ll say is that there’s never a good time to start a mediocre business. If you write an excellent business plan, and if you consistently deliver excellent care and service to your patients, you will be successful with your direct primary care practice, regardless of the greater economic forces. On the other hand, if you start a mediocre DPC practice, that gives okay service, that doesn’t put customers first, you’ll have a difficult time regardless of the economic ups and downs.

What is the most important thing that you can do to build a strong Direct Primary Care business, regardless of the economy?

The most important thing that you can do to build a strong direct primary care practice is to build trusting relationships with your patients and the broader community. As long as you’re producing quality care and not mediocrity, you can build strong relationships with your patients. With everything going on in the world today, with our economy taking a hit from the Coronavirus and people who are scared of the global pandemic, people are looking for a trusted physicians to talk to.

This is where you come in - you can be that trusted physician to help guide your community through these troubling times. You can communicate your knowledge in an understandable way and help people to navigate these difficult times. You can provide people with affordable and accessible healthcare, even as they lose employment and therefore their health insurance policies.

How to Weigh Price and Value when selling your Direct Primary Care services

If you're adding value to a consumer, you'll be in business. The value proposition is measured in terms of value versus price. If you believe you're offering value and a quality service but aren't seeing customers, marketing is needed. If your marketing plan is solid and customers know about you, but you're not getting business, you should re-evaluate your value proposition.

If you still can't figure it out, find a business strategy expert who will work with you to increase your chances of success. They can help you find the gap in your marketing plan and business plan, and help you break through whatever gaps exist.

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE Practice?

If you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC

How to Communicate Your Value as a Direct Primary Care Doctor During Times of Coronavirus

The Coronavirus is here in the United States and it’s causing new infections, hospitalizations, and deaths. People are scared about their own health and they’re worried about the health of their communities. People are looking to their doctors for answers during this time. In this blog post, I’m going to address the following:

• What can you do during this coronavirus pandemic?

• How can you communicate the value of your Direct Primary Care practice during this time?

• What are the most effective mediums of communication?

• What are some examples of successful Direct Primary Care doctors who are communicating clearly during this time?

What can you do during this coronavirus pandemic?

As a primary care doctor, you are uniquely positioned to address the public and the concerns of the public with excellent information. You want to provide the public with information that is evidenced-based. Avoid making prognostications or letting your opinion seep in. Stick to the facts and best practices.

Additionally, keep an even keel and a calm demeanor. If you look anxious or scared, your patients will pick up on this. If you look calm and collected, your patients will take note and they’ll be more trusting of your advice.

How can you communicate the value of your Direct Primary Care practice during this time?

You can communicate your value by telling folks what you do and how you’re uniquely situated to triage patients. Let people know that you can help them and guide them to the best care possible. This is what you’ve been trained to do - to triage patients, to treat people with medical concerns - now you just have to communicate that ability with your broader audience.

What are the most effective mediums of communication?

Your most effective means of communication are Facebook Live streams, Facebook videos, and YouTube videos. It’s difficult for people to read a lot of information about the coronavirus, so if you can break it down in a digestible format as a video, you will be able to reach a broader audience. You can supplement this video content with written content either in the notes below the video on Facebook or LinkedIn or as a separate blog post.

Examples of successful Direct Primary Care doctors who are communicating clearly during this time

There are a number of Direct Primary Care doctors communicating information clearly to their patients and their communities. I’ll use myself as an example to start and then showcase a few others. So this is a Facebook Live video that I put up on Facebook. It received 180 reactions, 117 comments, 85 shares, and 4,500 views to date. I then downloaded the Facebook live video, uploaded the video onto YouTube and created a blog post around the content. We had 10 new patients enroll in the 24 hours after posting the video.

The next video was not a live video, and a second update on the Coronavirus. I discussed why we’re enacting social distancing and how it can slow the spread of the viral infection. This video received 108 reactions, 27 comments, and 55 shares after posting it.

Dr. Delicia Haynes and her video

Delicia Haynes has a great presentation style and I love what she says here: “It’s Time for Precaution not Panic: Tips For Individuals and Business Owners to stay COVID-19 Free.” Dr. Haynes is the Founder at Family First Health Center in Daytona Beach, Florida.

Focus on her body language, the lighting, her tone of voice, and her speech pattern. She looks directly into the camera, she has nice lighting on her face, and she is in the center of the camera. These are all great. She keeps an even tone of voice and she speaks at an even pace. These are good things as well.

What if you don’t like to be on camera?

If you don’t like to be on camera, it’s a missed opportunity. However, you can make up for it by sending patients emails with photos of yourself in the office. Photos are important because people are way more likely to engage with visual media than with written posts.

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE Practice?

If you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC

Which is the Best Direct Primary Care Conference?

Why should you attend a Direct Primary Care Conference?

If you are looking to start and grow a direct primary care practice, you should definitely attend one or all of the major direct primary care conferences held in various locations across the US. These will be especially important for in-person networking and meeting other courageous physicians who are starting and growing their direct primary care practices. It will also show you what’s possible for you, your practice, and your future.

All of these conferences are excellent, and they each have their strengths and weaknesses. In general, these conferences are great places to learn about the practice of direct primary care and to connect with thought leaders and colleagues. There’s a distinct ethos of the DPC movement, and you can immerse yourself in this environment and learn some of those intangibles that are hard to pick up through other mediums.

You can find doctors who are practicing in your community and start building some mentoring relationships that can be valuable over the long term. You can also find a cohort of DPC docs who are at a similar stage in their journey. Take the time to connect with these doctors as well, as you will likely face similar challenges in your individual practices.

What are the three major Direct Primary Care Conferences?

The three major direct primary care conferences are the AAFP DPC Summit, the Docs 4 Patient Care Foundation DPC Nuts and Bolts Conference, and the Hint Summit. In short, you can benefit from all three conferences. It might come down to cost and geography for you, but there’s value with each conference. 

Here’s what’s on tap for 2020:

The American Academy of Family Physicians (AAFP) DPC Summit

The AAFP DPC Summit in June or July of each year caters to independent direct primary care physicians, and DPC doctors set the agenda. There are typically three days of educational sessions with a broad range of topics. The location bounces around the country and has been in Chicago (2019), Indianapolis (2018), Washington D.C. (2017), and Kansas City (2016). The 2020 conference will return to Kansas City from July 17th to 19th.

The focus is on the independent Family Medicine DPC practice, but there’s also information for larger DPC practices as well as more corporate DPC structures. The content and speaker selection is driven by a group of ten or so practicing DPC doctors and a few medical students and residents. There are scholarships available for medical students and residents, and the application can be found on the AAFP website. Further, Internists, Pediatricians, and Medicine-Pediatric doctors have also been known to attend.

In 2017 I was a panelist at the AAFP DPC Summit on starting a direct primary care practice, in 2018 I was a main-stage speaker and delivered “DPC Hustles Harder”, and in 2019 I was a main-stage speaker discussing how to build your personal brand to grow your direct primary care practice.

Dr. Paul Thomas of Plum Health DPC delivering his “DPC Hustles Harder” Presentation at the AAFP DPC Summit on building a strong business brand and a strong personal brand to grow your Direct Primary Care practice.

The Docs 4 Patient Care DPC Nuts and Bolts Conference

The DPC Nuts and Bolts Conference presented by the Docs 4 Patient Care Foundation is in Orlando each November, usually during the first or second full weekend in November. Dr. Lee S Gross organizes the Nuts and Bolts Conference, and he is a relentless advocate for the DPC model and movement. After the 2018 Nuts and Bolts conference, he posted this on his Facebook page:

I spent this weekend with some of the most inspirational and brave physicians I have ever met. It is time for physician leaders to step up and take back control of health care on behalf of our profession, our patients, and our nation. It is time for us to call out those that put themselves in between the doctor and patient.

I’ve saved this specific quote from Dr. Gross because it’s so damn inspiring – I’ve read this aloud at the AAFP DPC Summit 2019 and got chills as I said it on stage in front of 300 or more doctors.

Within this quote is a great mission statement: I believe that it’s time to take back health care for our profession, our patients, and our nation. Inspiration from Dr. Gross and other attendees comes standard at the Nuts and Bolts Conference.

The DPC Nuts and Bolts Conference is valuable in that there’s excellent DPC content and a strong showing of practicing and prospective DPC docs. The only point of contention with this conference is that there are some political overtones and some speakers with a political agenda.

Dr. Paul Thomas of Plum Health DPC at the podium during the Docs 4 Patient Care Foundation Nuts and Bolts Conference, sharing about passion, purpose, authenticity and caring. — with Ellen McKnight, Chad Savage, Josh Umbehr, and Lee S. Gross at Rosen Hotels & Resorts Orlando.

The Hint Summit

The Hint Health Summit is usually held in San Francisco each year, but in 2020, it’s moving to Denver. Hint Health sponsors this conference, and they describe themselves as “the direct primary care solutions company that partners with visionary provider organizations to build successful DPC programs.”

Paul Thomas, MD of Plum Health DPC at the Hint Summit 2018 - the conference topic was Breaking the Status Quo in health care and ZDoggMD was the keynote speaker!

I attended the Hint Health Summit in 2018, and I enjoyed it immensely. I got to rub elbows with speakers like Zubin Damania aka ZDoggMD, Garrison Bliss, Clint Flanagan, and Zak Holdsworth. For the Hint Summit, Hint Health has a bigger budget and can afford big name speakers like ZDogg MD and Marty Makary et al. But, they are trying to sell you a product, the Hint billing platform.

The one criticism that I have is that the content is tailored for larger DPC groups and more corporate DPC structures. Because of this, the content was not as valuable for an independent DPC practice like mine relative to the content presented by the AAFP and the Docs 4 Patient Care Foundation. However, I have heard that there may be some changes to the 2020 Hint Health Summit content and format.

This is a good opportunity to introduce this concept: it matters who you spend time with, and by spending time with successful and inspiring people, you can raise your frequency and increase your chances for success. Motivational speaker Jim Rohn famously said that we are the average of the five people we spend the most time with.

By immersing yourself in these conferences with exceptional DPC docs, you will pick up on the pearls, the tips, and the idiosyncrasies that make these doctors successful. Your choice to attend these conferences will depend on costs, distance traveled, and proposed content.

All three conferences are great for networking. They will raise your frequency and show you what’s possible for you and your practice in DPC and beyond. 

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE PRACTICE Right Now?

If you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC

Startup DPC Mailbag: Questions about Starting a Direct Primary Care Practice right out of Residency

This is Dr. Paul Thomas with Startup DPC (https://www.startupdpc.com/) and I receive new questions each day about how to start and grow a Direct Primary Care practice. I believe in the power of the Direct Primary Care model to restore our broken healthcare system for both patients and doctors. That's why I'm really passionate about this topic and why I'm on a mission to educate my fellow physicians and the public about their options in the direct primary care model.

Our questions today come from a Resident Physician in Florida. Here's the questions:

If I have a big student loan debt, can I still start a direct primary care practice?

1. How did your decision to pursue DPC work affect your student loan repayment strategy?

I graduated from Residency with a student loan burden of $170,000. This was the average student loan burden for graduates in 2013. In 2019, the average student loan burden increased to $190,000. That being said, I went on a straight 10-year repayment plan, and I spent about $2,000 each month on my student loans.

In order to do this, I didn't splurge on unnecessary expenses and I focused on the practice I wanted to build. I also started moonlighting as soon as possible in residency to have enough money to pay down my student loans and have a comfortable lifestyle.

In short, my large student loan debt did not deter me from starting my direct primary care practice. My mission of serving others via this DPC model outweighed any misgivings I had about a large student loan balance. If you have a dream of starting a DPC practice, you can do it, even if you have a big loan balance.

How do you build a strong personal brand while a Resident Physician?

2. As residents, we’re mostly responsible for our patients. We connect with some of them but don’t know how to engage them while they wait for us to complete residency, what was your strategy?

This question is really about building a strong personal brand, and how do you build a strong personal brand in during your Residency training. It comes down to engaging with people in your community in a positive way.

Be a leader, a volunteer - work with different free clinics or hold a board position. Reach outside of your network and get to know professionals from other fields, like law, finance, philanthropy, the food and beverage industry, the hospitality industry, and others.

You can also take time to build your presence on one or all of the following social media channels: Facebook, Instagram, Twitter, LinkedIn, YouTube, TikTok, or SnapChat. If you build a strong personal brand on these channels, you'll be more easily able to invite your audience to become patients of your direct primary care practice.

I take a deep dive on these concepts in my course on Attracting Patients to your Direct Primary Care practice, here: https://www.startupdpc.com/take-action

Can you work a second job (moonlight) while starting your direct primary care practice?

3. Private practice finance is a big issue, didn’t working multiple jobs interfere with your time commitment to your private practice patients?

No, you can work 20 hours a week pretty easily while you start your direct primary care practice. For me, I was moonlighting for 12 hours on a week day and 8 hours on a week end day and earning enough to support myself and pay down my student loans.

I worked at an urgent care for $70 to $80 an hour, which allowed me to grow my direct primary care practice organically. I worked at my DPC practice 4 days each week and at the urgent care 2 days each week. I was able to care for and manage my DPC patients easily over that 4 day work week, as I had fewer patients at that time.

HOW CAN I LEARN MORE ABOUT STARTING A DIRECT PRIMARY CARE PRACTICE?

If you want to learn more about starting and growing your direct primary care practice, look no further than our courses on how to start and grow your direct primary care practice. We at Startup DPC have 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!

- Dr. Paul Thomas with Startup DPC