Direct Primary Care

Reviews for Dr. Paul Thomas at the DPC Summit 2021

Dr. Paul Thomas at the DPC Summit 2021

On July 17th, 2021, Dr. Paul Thomas presented at the DPC Summit 2021, hosted by the American Academy of Family Physicians. It was a phenomenal, and well-attended event, and it was an honor to be a part of it and presenting at such an important conference.

The presentation focused on branding and marketing for direct primary care doctors. Family doctors are not taught how to promote themselves or their work in a meaningful way. This presentation focuses on how to do just that, and how to attract new patients to a family medicine practice. It focuses on leveraging social media channels, search engine optimization, and social media.

Paul Thomas, MD presenting at the DPC Summit 2021 hosted by the American Academy of Family Physicians.

Reviews for Dr. Paul Thomas at the DPC Summit 2021

Dr. Paul Thomas’ session at the DPC Summit 2021 hosted by the American Academy of Family Physicians received high reviews for the effectiveness, clarity, organization, and subject knowledge of the presentation. Dr. Thomas’ presentation focused on Branding and Marketing for Direct Primary Care Doctors.

Here are some of the reviews for Dr. Paul Thomas’ presentation at the DPC Summit 2021:

  • This is consistently one of the best presentations that provides the most relevant content for the doctor just starting out their DPC practice. I would recommend this particular session for anyone before they decide on a name, even, as the information provided about that simple (not so simple) decision can make the rest of marketing, branding, etc. even easier.

  • Dr. Thomas was excellent as always! Gained a lot of insight into how to run social media with a DPC practice. Wow, that guy has energy. wondering when he has time to do any patient care with all that energy in marketing. If I decide to do this I will definitely use his information as a resource.

  • Enthusiasm and clear joy in practice was inspiring -- appreciate the broad overview of the basics that go in to branding as well as the resources shared

  • Dr. Paul, your book is great! Would like to visit you/your practice before I start my own DPC in California on 2022.

  • Wow, I learned so much from this. I feel like I know so little. This was wonderful

  • Really great speaker with passion.

  • Outstanding marketing info. Great principles. I'll be studying this!

  • Wonderful lecture for options and guidance on marketing

  • Such a great talk- thank you! | Enjoyed the book | Wonderful presentation!

Dr. Paul Thomas’ session at the DPC Summit 2021 hosted by the American Academy of Family Physicians received high reviews for the effectiveness, clarity, organization, and subject knowledge of the presentation. Dr. Thomas’ presentation focused on Branding and Marketing for Direct Primary Care Doctors.

You can see the full agenda for the DPC Summit, here: http://www.dpcsummit.org/agenda.html

Paul Thomas MD at Hint Summit 2021

Paul Thomas, MD will be Presenting at the Hint Summit 2021

This Thursday, I’ll be leading the Direct Primary Care Accelerator at the Hint Summit 2D’21, which will help doctors start and grow their direct primary care practices. I’m really excited to be working with Hint Health and their team to give the best information in a short amount of time to the aspiring and growing DPC doctors. It’s important to know that this conference is FREE for students and residents, so register today!

Dr. Paul Thomas will be speaking at the Hint Summit 2D’21

Here’s what the Hint Team has to say about the upcoming Hint Summit:

Hint Summit 2D'21 is less than a week away, running Thursday and Friday, October 28-29th. Register now and join hundreds of other DPC professionals and business leaders for this year's virtual event! Hint Summit will provide you with the most up-to-date information on alternative primary care payment & delivery models as well as personal stories from pioneers of this movement.

Hint Summit 2D’21 Session Highlights

  • Collaborations Transforming the Health of our Nation, One Community at a Time

  • Forward-looking Care Delivery Models to Serve Your Patients & Grow Your Practice

  • Healthcare House of Cards: A System Ripe for Disruption

  • Advancing Direct Care Models through Employer-Sponsored Plans

  • Digging into the Way We Pay for Healthcare

  • Advanced Primary Care: Integrating Specialties into Your DPC Practice

Audience-favorite DPC Speed Dating is back!

You’ll meet old friends and make new connections through this fun, rapid-fire networking activity.

Interview for the DO Magazine

This week, I was interviewed for the DO (Doctor of Osteopathic Medicine) Magazine by one of our rotating students. Here’s what I had to say:

What would you like residents and attendings to know about opening and running a DPC?

  • At the core, practicing in a direct primary care (DPC) model allows physicians to engage in work that is satisfying. We can all agree that work is satisfying when we have autonomy, we can engage in complex decision making, and when there's a direct relationship between effort and reward. Unfortunately, these factors are slowly being eroded from employed practice in large health system groups or in insurance-based primary care.

  • As a direct primary care doctor, you have the ability to regain your autonomy, to be your own boss. You set your schedule, you determine the price points, you decide on which days you work, you decide when you go on vacation, you decide on which medications you will stock, and you determine which areas of medicine you will focus on. Interestingly, by doing this, by practicing on your terms, you will attract a certain patient or customer for whom this style of practice resonates. You will find patients who respect, appreciate, and seek out care from the authentic doctor who has established this DPC practice. It’s hard to put this concept into words, but you may find your patients have a lot in common with you in interests and in personality.

  • When I finished my first book on direct primary care, I sent a press release about its publication to Devin Scillian of WDIV and host of the Flashpoint program. He invited me to an interview on his program after he received the press release and asked some very insightful questions. He closed the interview with the topic of money – “I don’t know how to ask this delicately, but is this lucrative for you? Do you make a fair amount - enough money? Or are you just messing with the system?” Now this is something that we talk about at every national DPC conference. My answer was informed by a panel of physicians at the 2017 DPC Summit hosted by the AAFP. The moderator asked if the panelists – a smattering of doctors in vastly different DPC practices – were making more or less money. The consensus seemed to be that folks were making slightly less money but had much greater fulfillment because of the autonomy that they experienced while practicing in the DPC model.

  • Informed by that conversation, I followed with this answer, “As the membership grows, as the doctor gets to full capacity, you earn about what you would make as an employed physician, maybe a little bit less. But, we have a saying in the direct primary care movement that nothing pays like autonomy. I can be the physician I was meant to be. And, in this model, it’s really inspiring for other doctors who want to join this movement because you have the ability to practice medicine on your own terms, and not at the dictates of insurance companies or government health care systems.” You can see the full interview here: https://www. plumhealthdpc.com/blog/2018/12/23/family-doctor-on- flashpoint-with-devin-scillian .

  • And for me, five years into the practice, this feeling still holds true and still resonates with me. I’m making slightly less than I would have had I signed the contract with the large hospital system. But, that higher income would have come with seeing 25 to 35 patients each day. That higher income would have come with less time with my family and more time clicking check boxes. That higher income would have come with less time for self-care and a higher risk of burnout. That higher income would have come with a decline in my mental and physical health.

  • And you’ll find that I’m not alone in how I feel about this topic. You will find that DPC docs are a self-selecting group who take risks for the sake of their independence and the integrity of their practices. They continuously advocate for policies at the State and National level that protect their ability to practice with autonomy. DPC Docs aren’t likely to make or keep alliances with larger organizations at the expense of their autonomy. As long as we stay alert and proactive, DPC and independent practice will thrive.

How has Plum Health navigated the business challenges of a DPC practice?

  • Many doctors look at the direct primary care model and practice style wistfully. They see the benefits for both patients and doctors and they aspire to become a DPC doctor. However, they think that this is only achievable after becoming an MBA. But… You DO NOT need an MBA to be successful as a DPC doctor - if you’re smart enough to finish medical school, gritty enough to complete residency, and compassionate enough to choose primary care, then you have ALL of the ingredients of a successful DPC doctor and business owner. Direct primary care is all about removing the middle men and the barriers between doctors and patients. What makes this DPC practice model so unique and so powerful is the doctor’s ability to get rid of the unnecessary steps and intermediaries between doctor and patient, delivering a streamlined and intuitive primary care service to patients. So doctors, I know that it can be a scary leap to go from an employed physician with no training in branding, marketing, sales, web development, search engine optimization, and other essential skills for a successful DPC practice, but you don’t need to hire an MBA to do this. What you can do is read through the available resources in the DPC ecosystem, learn the new skills that you can, and hire individuals for the skills you don’t have, but you do not need to hire an MBA to manage the entire process. We need more doctors to stand up, start their own practices, and take back medicine for the betterment of the doctor-patient relationship and the health of our communities.

You do not need an MBA to be a successful DPC doctor.

You do not need an MBA to be a successful DPC doctor.

What is your story? What attracted you and how did you get involved with a DPC practice?

  • I initially discovered direct primary care while on a road trip – I was driving back to Detroit from a residency position interview at the University of Minnesota. I heard a podcast interview with none other than Dr. Josh Umbehr discussing his startup in Wichita, Kansas. It was refreshing to hear a Family Medicine doctor speaking so passionately about saving people money, delivering better care, and practicing in a unique way. The message resonated with me, but at that time I was pursuing a faculty position at a residency program because I enjoyed teaching so much. Suffice it to say that I filed this “direct primary care” concept in the back of my mind.

  • Between my second and third years of residency, I went to the Michigan Academy of Family Physicians (MAFP) annual meeting in Traverse City. It was July 2015 and a full year before I graduated from Residency. This was a critical moment because I had to decide in which direction I would take my career. There I met Dr. Clint Flanagan of Nextera Healthcare in Boulder, Colorado. He spoke unequivocally about the value of being a primary care doctor and the tremendous value that we provide for our patients. His passion for the profession came through in a way that I hadn’t experienced before.

  • These two leaders in the field served as a contrast to the typically burnt out and grumbling physician that I had met thus far in training. Even the best doctors grumbled about paperwork, prior authorizations, late patients, packed schedules, and all of the other difficult parts of being a primary care doctor. At that point, I knew that I would pursue an alternative practice model. It only made sense – less-than-fulfilled physicians practicing in a less-than-ideal system surrounded me and I knew that life could be better on the other side.

  • Additionally, I always had this inner drive to deliver medicine in a more equitable and just system. Direct primary care seemed to align with my values as an individual and as a doctor, but I needed to dive deeper. As an elective rotation, I drove out to Wichita, Kansas and Boulder, Colorado and spent a week learning from both Drs. Umbehr and Flanagan. I kicked the tires, took copious notes, and tried to bring the best of their practices to my community in Detroit, Wayne County, and Southeast Michigan. How did I accomplish this feat in the middle of residency? I wrote an elective rotation curriculum for myself and I presented it to my Program Director. I was the Chief Resident during my third year, and she accepted the curriculum that I gave her. It allowed me two weeks of travel and immersion time in these practices and I had to meet the criteria that I set forth in my curriculum. If you’d like to download that elective rotation curriculum, you can find it on our website: www.StartupDPC. com.

  • At this point, I had already written my business plan. You see, a few months prior to the elective rotation, I had taken a mandatory rotation called Practice Management. During that rotation we had to write a business plan for a potential clinic. They had intended the assignment to be an exercise in futility wherein you became overwhelmed by the complexities of running a practice in the fee-for-service system. Instead, I wrote a relatively simple eight-page document demonstrating how I would run my direct primary care practice. With my business plan in hand, I spent time with Drs. Flanagan and Umbehr and learned a great deal about their practices. They also read over my business plan and gave me their advice and critiques.

How has Plum Health fostered a better doctor-patient relationship?

  • We value the doctor-patient relationship. We intentionally set up one-hour initial appointments and thirty-minute follow- up appointments so that we can have enough time to really get to know our patients. We also have enough time to engage in shared doctor-patient decision-making, and thereby empower our patients to make the choices that are best for their health, wellness, families, and budgets.

  • We value autonomy, the ability to choose what is best for our patients apart from the insurance company mandates and algorithms.

  • We also value price transparency for our healthcare services, so our patients can make the best decisions possible for their personal and financial wellness.

How has Plum Health achieved the quadruple aim of medicine-- improving the work-life balance of physicians to make the triple aim of medicine happen?

  • I believe that the direct primary care model empowers patients with a transformative opportunity to take more personal responsibility for their health. By practicing in a DPC model, you will empower your patients to take better care of themselves. For example, I met a man named Frank last year who enrolled in our practice at Plum Health DPC. Frank works as a truck driver and delivers medications and supplies for a local pharmacy company. His employer does not provide health insurance and he earns too much to be enrolled in Michigan’s Medicaid program. But, his salary isn’t high enough for him to comfortably afford health insurance. Frank knows that he has high blood pressure and diabetes, but it was too expensive for him to access the fee-for-service system. When he tried to use the fee-for-service system, he spent about $100 monthly for medications and around $500 for a visit with lab work to check his kidney function, electrolytes, and long-term blood sugar values (hemoglobin a1c level). Because of this high cost of care, Frank neglected his personal health. Unfortunately, due to his uncontrolled diabetes, Frank went to the hospital for a large abscess in his right hand. Frank required a long hospital stay with intravenous antibiotics and a complex incision and drainage procedure, followed by further debridement of the wound. At the time of discharge, the discharge nurse informed Frank of our Plum Health DPC practice. Frank signed up that day, and followed up with us the day after discharge. We reviewed all of the medications he was taking – a statin for high cholesterol, two blood pressure medications, and two insulin products. These medications might have cost $100 to $200 monthly at the pharmacy, which would have been cost- prohibitive for Frank. Frank started with our practice, got his comprehensive metabolic panel for $6, his Hemoglobin a1c for $6, and a 90-day supply of his medications for $11.52. We gave him 90 tablets of the lisinopril, 180 tablets of the metoprolol, and 90 tablets of the statin for that $11.52. We were able to get Frank’s Tresiba and Novolog for free from NovoMedLink, a special program from Novo Nordisk. What happened after was tremendous – Frank started to actively manage his medical conditions. He took an active log of his blood sugar levels, and had fasting glucose levels of 139 mg/ dL, 121 mg/dL, and 111 mg/dL during his first week of taking the new regimen. We talked and he told me that this was the first time that his medical problems felt manageable. There are so many people who have given up on taking care of themselves because health care has become too complicated and expensive. As DPC doctors, we have a unique opportunity to empower our patients to live their best lives. For me, helping people like Frank is the reason why I started my direct primary care practice and why I continue to work diligently in my DPC practice. I believe that health care should be affordable and accessible, and the opportunity to serve people like Frank makes that personal and professional mission come full circle. Caring for Frank and patients like Frank allows me to achieve my Ikigai, my reason for being. When I am able to solve complex challenges for patients and empower patients to take care of themselves, I am fulfilling my purpose and working in my true vocation. I am good at this job, I’m delivering a service that the world needs, I’m being paid for this work, and I’m doing what I love. These are the elements of the Ikigai framework, and they are fulfilled in caring for folks like Frank. I’m proud of the work that I do and I am grateful to have the opportunity to serve people and the greater community in this way, and I’m very excited for you to have this same opportunity.

How has the COVID-19 pandemic affected Plum Health?

  • We have had to become more flexible in our health care delivery.

  • We have shifted to more curbside testing and virtual care to ensure the safety of those that visit us in the clinic.

  • Direct primary care and the continuous revenue stream from monthly billing, has allowed us to have a stable income during this time

  • We weren't fired or furloughed by a larger health system, or replaced by mid-level providers during this time

  • In fact, our care has become more needed by our patients as they've been grappling with their typical health care concerns and all of the issues surrounding covid - vaccinations, infections, exposure, testing, etc...

Where do you see DPC practices going in the future?

  • There is likely an 80/20 rule at play

  • 80% of patients and physicians are fine with the current system

  • 20% of doctors and patients are looking for something like DPC, even if they don't know what to call it

  • Currently, only 1.5% of the primary care workforce practices in the DPC model

  • So, there is a huge growth potential for direct primary care

  • As more and more entrepreneurial and tech savvy doctors graduate from residency, we'll see more and more physicians adopt the DPC model

  • Further, doctors do not want to feel like cogs in the health insurance industrial complex, they want to have time to care for their patients face to face, time to understand them and time to make complex decisions, and the DPC model offers doctors that ability.

  • I'm excited to see more and more physicians offer this model and help their patients in this way.

HOW CAN I LEARN MORE ABOUT STARTING AN 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 book and 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, in our book, 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 Book Reaches 82 ⭐ ⭐ ⭐ ⭐ ⭐ Reviews

Startup DPC Book Reaches 82 ⭐ ⭐ ⭐ ⭐ ⭐ Reviews

Today, the Startup DPC Book reached 82 five star reviews! I’m really excited about this because it has helped so many doctors start and grow their own direct primary care practices. I really love seeing doctors pick up this book and use it to build their own practices and take care of patients on their own terms. I’m especially excited that more and more doctors are making health care more affordable and more accessible for people in their communities.

Here’s what some of our most recent reviewers had to say:

5.0 out of 5 stars DPC for the win

Reviewed in the United States on September 25, 2021

Verified Purchase

This is the third book I have read to help me get started on my DPC journey and it’s by far the most complete. Thank you so much for putting pen to paper and really getting the most information into one book. Learned quite a few things I did not know. Definitely a great book for anyone considering DPC

Only Book Necessary to Start a DPC

Reviewed in the United States on August 8, 2021

Verified Purchase

Fantastic and comprehensive guide to starting your own DPC. Whether you are coming out of the gate from residency or converting your current practice, Dr. Paul Thomas has written an easy to follow strategy to set you up for success. My copy has so many sticky notes of great advice and further resources to dive into also. This is the one book you need to help you begin a thriving DPC practice and see it grow. Highly recommend this and will be referencing back to it often!

Thank you for reading, and thank you for helping us get to this milestone!

The Startup DPC Book Reaches 82  ⭐ ⭐ ⭐ ⭐ ⭐ Reviews - thank you for helping us reach this milestone!

The Startup DPC Book Reaches 82 ⭐ ⭐ ⭐ ⭐ ⭐ Reviews - thank you for helping us reach this milestone!

Here’s what I wrote about the book when I first published it on May 5th, 2020. I believe that it still holds true today:

We all know that our current healthcare system is broken, especially for primary care doctors and their patients. Primary care physicians have to see more and more patients in less and less time in order to keep up with declining reimbursement from insurance companies. This leads to rushed office visits, missed opportunities for genuine connections between doctors and their patients, frustrated patients, and burned out doctors. But it doesn't have to be this way.

Direct primary care offers a real opportunity at a fulfilling practice of medicine. It’s a golden opportunity to restructure your time, build the practice of your dreams, and spend your best hours taking care of patients and prioritizing your family life, rather than wasting time as a data entry clerk for an insurance company. In short, direct primary care gives you the opportunity to become the doctor that you're meant to be.

But how do you get this done? How do you go from a less-than-fulfilled doctor in the dysfunctional fee-for-service system to an empowered, entrepreneurial direct primary care physician capable of starting their own successful DPC practice?

The answers you're seeking are in this book!

My name is Dr. Paul Thomas, and I'm a Board Certified Family Medicine Doctor - I launched my own direct primary care practice straight out of residency in Southwest Detroit with over $100,000 in student loan debt. In my first month of practice, I had 7 patients. A few years later, we have over 700 patients, and I've hired a medical assistant and a second family doctor to help me manage the growing demand for our services.

I was named the entrepreneur of the year in 2018 by the Detroit Vanguard Awards, I gave a TEDxDetroit talk on direct primary care, and I've been featured in the Detroit Free Press, Reason Magazine, CBS Radio, Detroit's ABC affiliate WXYZ, Detroit's NBC affiliate WDIV, and Crain's Detroit Business. I've also been a speaker multiple times at the American Academy of Family Physicians (AAFP) DPC Summit, the Direct Primary Care Nuts and Bolts Conference, and the Hint Health DPC Summit.

In this book, I'm going to teach you everything I know about direct primary care and about starting a successful direct primary care practice. Here's a smattering of the topics that we'll cover:

- How to have the right mindset to be successful in your direct primary care journey
- How to become the doctor you're meant to be
- What a typical day looks like for a direct primary care doctor
- How to finance your direct primary care startup
- How to raise money for your DPC practice
- How to overcome a lack of business training in medical school and residency
- How to construct the perfect timeline for starting your DPC practice
- How to write a business plan for your direct primary care clinic
- How to start a direct primary care practice straight out of residency
- How to convert an existing fee-for-service clinic to a direct primary care practice while remaining profitable
- What's the difference between direct primary care and concierge medicine
- How to hire a second doctor for your DPC practice
- How to find a profitable location for your DPC practice
- How to negotiate a lease deal for your medical practice
- How to build out the medical office of your dreams
- How to attract patients to your direct primary care practice
- How to brand your practice so you stand out in your marketplace
- How to build your personal brand to grow your direct primary care practice

And so much more!

By picking up this book, you may be taking your first step in starting your direct primary care practice, or you may be taking the next big leap in growing your direct primary care practice. I know that whoever you are, and whichever stage you're at in your DPC journey, this book will inspire you and demonstrate in concrete methods how you can be even more successful.

Here's to your success in the growing DPC movement! - Dr. Paul Thomas

How to Find a Media Release Form for your Direct Primary Care Practice

How to Make a Media Release Form for your Direct Primary Care Practice

While marketing your practice, you may want to share photos of you taking care of your patients. You can get a verbal consent for this, you can get a written consent for this (via email or text message), but it’s probably best to get a written consent to share people’s likeness on your social media channels. Here’s a sample release that I use for this channel, but it would be easy to update it for your patients in your practice.

If you’d like the PDF copy of this information, please send me your email address, and I’ll send it over! Use the subject, “Please send me your media release form!”

HOW CAN I LEARN MORE ABOUT STARTING AN 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 book and 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, in our book, 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 Spend Your Startup Budget for Your Direct Primary Care Pracitce

This week I got a great question! How do I spend my startup budget for my DPC practice? Here’s my answer:

  • $3,000 for web design services

  • $2,000 - $3,000 for outfitting your first exam room with great equipment (exam table, diagnostic set, BP cuff)

  • $2,000 for an EKG machine

  • $2,000 for other office furniture and supplies (nice sofa and chairs, computer, printer, Dymo label printer, etc...)

Web design services are important because people/your potential patients will be purchasing your service through your website. You want a website that is easy to navigate and easy to use, while being informative and clear on what you do and what you don’t do.

You should also spend money on making your office look great to ensure that your patients have a seamless experience from interacting with you on social media, to purchasing your membership services through your website, and then through their appointment in your office.

That Dymo label printer is clutch, as you’ll use it for your medication labels and your laboratory orders. I also wrote a blog post about which EKG machine to buy for your DPC practice.

Best of luck in your journey!

- Dr. Paul Thomas

Ten Common Questions and Answers About Direct Primary Care

1.) What is Direct Primary Care?

Direct primary care uses a membership model to deliver health care services directly to patients. Direct primary care (DPC) doctors don’t bill or use insurance. Rather, patients pay a monthly membership of $50 to $100 to receive primary care services directly from a board-certified family medicine physician or other primary care specialist.

2.) Why are primary care doctors choosing direct primary care over fee-for-service medicine?

Fee-for-service medicine often comes with a lot of unnecessary stress - there are so many prior authorizations and billing headaches, and doctors have to see more and more patients in less and less time. Doctors feel like they are losing their autonomy in these fee-for-service or insurance-based health care delivery models. Direct primary care offers a great alternative health care model to the typical fee-for-service set up. In the DPC model, doctors have more autonomy and they are able to have more time with each patient.

3.) How many patients do DPC doctors have in their panel?

Most DPC doctors have about 400 to 700 patients in their panel. This is in stark contrast to fee-for-service doctors who are mandated to see about 2,500 in their panel. I say mandate because fee-for-service doctors are often employed and they are told to see 25 to 30 patients each day, which translates to 18 to 20 minutes per patient visit.

4.) How many patients do DPC doctors see each day?

Direct primary care doctors see about 5 to 10 patients each day. Typically, family physicians see 1% of their panel each day. DPC doctors have about 500 patients in their panel, so they see about 5 patients each day. This allows doctors in the DPC model to have about 1 hour with each patient.

5.) What is the value for a community member who wants to sign up for a DPC practice?

People sign up for direct primary care practices because they can see their doctor when and for as much time as they need to. Doctors typically guarantee same-day or next-day appointments, which makes seeing the doctor convenient. People also choose DPC practices because they get clear communication with their doctor. DPC doctors often share their phone numbers and email addresses with patients.

6.) How many DPC doctors are practicing across the country?

When I first started my practice in 2016, there were roughly 300 direct primary care doctors practicing across the country. Now, there are about 1,500 direct primary care doctors practicing across the country. In context, there are roughly 133,000 family physicians in the United States, and that means about 1% of those doctors are engaging in the DPC model.

7.) How do you prescribe and dispense medications in a direct primary care practice?

Direct primary care doctors often buy medications at wholesale prices and then pass on those savings to their patients. We buy from a company called AndaMeds out of Florida, and this is the same wholesaler that supplies big box pharmacies. We use an inventory system in our EMR and then dispense those medications to our patients as needed.

8.) How do you get lab work done for your patients in a direct primary care practice?

We have a contract with Quest diagnostics in order to get lab work done for our patients in our direct primary care practice. We draw the blood in the office and then we send the labs to Quest (they pick it up from a box on the back of our office). We then get the results next day or up to 48 hours later for certain tests. We are able to save patients 50 to 90% on their lab costs.

9.) What about imaging services in direct primary care practices? How do patients get radiology services in direct primary care practices?

We contract with a local imaging center and our patients can go to this imaging center and save 50 to 90% on their imaging needs if they pay cash. For example, a chest x-ray of the anterior/posterior and lateral views is $45. An MRI of the knee is $300 with our local imaging center.

10.) Wow, this sounds like a great system! Why aren’t more doctors engaging in direct primary care medicine?

That’s a great question! The biggest barrier for typical doctors to start a direct primary care practice is fear. First, they don’t have any business training, so starting their own business is daunting. Second, they may not want to leave the steady paycheck of a large health care system and go out on their own. That’s why I’m here - to teach and inspire so more people feel comfortable and confident to take the leap!

What Should You Keep In Your Doctor's Bag for A House Call?

What Should You Keep In Your Doctor's Bag for A House Call?

First, get a cool doctor’s bag, like this one in the image from Gustin!

Fill it with cotton swabs, bandages, alcohol wipes, blood pressure cuff, thermometer, pulse oximeter, stethoscope, nitrile gloves, diagnostic set (otoscope at least).

Sometimes my patients need a joint injection, so I'll pre-fill a syringe with lidocaine and triamcinolone and inject the knee or shoulder as needed.

Sometimes my patients will need a blood draw, so I'll pack a butterfly needle and the tiger-top tube and lavendar tube. I'll do this last, so I can head to the office and spin the SST/serum separator tube/tiger-top tube and have Quest pick this up.

Why Are House Calls Important?

I make house calls because I believe that healthcare should be affordable and accessible. 🥼

That accessibility piece can be out of reach for some elderly and disabled patients who cannot leave their home. This is especially true in Detroit, where nearly one third of Detroiters lack access to reliable transportation. 🚗

Studies on the effects of house calls on healthcare outcomes show fewer hospitalizations 🏥, fewer emergency room visits, decrease in re-admissions (going back to the hospital shortly after discharge), and these house 🏠 calls save patients money 💵.

That’s why it’s important for me to offer this vital service. This pic was taken last week in the Five Points neighborhood. I’m proud of this work and of how we’re able to lower the cost of care and make excellent health care available to more people.

The vast majority of our visits take place in our offices - we have two locations where we take care of people face to face and by using virtual visits. But, house calls can be used at any time to help our patients who are shut in, who have mobility issues, or who have concerns where they’d prefer not to leave their homes.

From the American Academy of Family Physicians:

House calls, also referred to as home visits, are increasing in the United States. Approximately 40% of patient visits in the 1930s were house calls. By 1996, this decreased to 0.5% because insurance reimbursements for house calls decreased. The pendulum in the United States is swinging again to house calls because of the need to develop care models for the growing aging population.

More information from the American Academy of Family Physicians on the benefits of house calls:

The Independence at Home program demonstrated a 23% reduction in hospitalizations, a 27% decrease in 30-day readmissions, and a cost savings of $111 per beneficiary per month, which is a $70 million savings over three years. Similarly, a large systematic review (N = 46,154; nine studies) evaluating home-based primary care outcomes for homebound older adults reported fewer hospitalizations, hospital bed days of care, emergency department visits, long-term care admissions, and long-term bed days of care.

Thanks for reading and have a wonderful day,

-Dr. Paul Thomas

HOW CAN I LEARN MORE ABOUT STARTING AN 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 book and 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, in our book, 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 Medications Do I Need to Start and Grow a Direct Primary Care Practice?

Which Medications Do I Need to Start and Grow a Direct Primary Care Practice?

Family medicine doctors who are starting direct primary care practices often ask me which medication they need for their direct primary care practice. There are literally thousands of medication that you can order for your practice, and those might include:

  • Amlodipine

  • Amoxicillin

  • Atorvastatin

  • Aviane

  • Bacitracin

  • Benzonatate

  • Boosterix (TDAP)

  • Buspirone

  • Bupropion

  • Carvedilol

  • Cephalexin

  • Clobetasol

  • Ciprofloxacin

  • Citalopram

  • Clindamycin

  • Dexamethasone

  • Dicyclomine

And on, and on, and on….

That being said, my best advice is to order only what you need for your patients when your patients need it. Otherwise, you could end up with a huge inventory of medication that may expire overtime, resulting in a financial loss. Most medications have a shelf life of 12 months to 18 months, so start by ordering a few medications in small quantities, especially if you’re starting from 0 patients or under 100 patients.

This may change if you have a full panel of patients. Simply look at their med lists and order the medications that these patients commonly use. Keep those medications stocked in your inventory, and dispense and re-order as needed.

Right now, our medication inventory is over $7,000, but we started with a $100 order of Lexapro, Amoxicillin, Albuterol, Lidocaine, and a box of Nitrile Gloves.

How to Order medications for your direct primary care practice

In order to get medications into your practice, you need to set up a relationship with a medication wholesaler. We have a contract with AndaMeds and Henry Schein, but you can also contract with Bonita Pharmaceuticals and others. We get free shipping when we order $100 worth of medications at a time, and we get overnight/next day delivery. Most of our meds usually arrive at 10 am the next day if we order by 9:30 pm. Isn’t that fast?

AndaMeds literally has thousands of medications to choose from. As we use up an existing supply of Omeprazole or Metformin or Sumatriptan, we go into AndaMeds and place the medication we need in the cart. Once the cart gets “full” meaning there’s over $100 worth of medications or supplies in there, we’ll order it/close out the cart and have the meds delivered next day. It’s just that easy!

See my video below for more information:

HOW CAN I LEARN MORE ABOUT STARTING AN 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 book and 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, in our book, 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

If You're A Burned Out Physician, Try Direct Primary Care

Is Direct Primary Care the Cure for Burnout?

If you graduated from medical school, completed residency, and chose a primary care specialty, you are in the top 1% of compassion, intelligence, and resilience. If you're feeling burned out, tired, and beat up by the system, it's not your fault - it's the healthcare system that is fundamentally broken, not you. You're not the one with the problem, it's the system that is fundamentally broken. Direct Primary Care can be your bridge to a fulfilling career in medicine, so take the next step.

The Startup DPC book by Dr. Paul Thomas. If you’re a burned out physician, try Direct Primary Care - you can do this!

The Startup DPC book by Dr. Paul Thomas. If you’re a burned out physician, try Direct Primary Care - you can do this!

While direct primary care is not a perfect system, it’s certainly closer to the truth than the typical fee-for-service system of delivering care. With direct primary care, doctors have about 30 minutes to an hour to spend with each patient. Doctors and patients can invest in a meaningful relationship, and that relationship-based form of medicine can be sustaining for both parties. Doctors feel like their work is valued and valuable, and patients feel heard and understood, and not just another number.

For these reasons, direct primary care can be a reasonable treatment for physician burnout. It comes with a different kind of stress level and a different kind of workload, but one that is ultimately manageable and fulfilling for doctors and their patients.

Thanks for reading,

-Dr. Paul Thomas

STARTUP DPC - DIRECT PRIMARY CARE MASTER CLASS

Because there are no in-person conferences this year, we are hosting an intimate gathering of Direct Primary Care doctors who are looking to start and grow their DPC practices. We did this last year, and it was a rousing success! Join our Direct Primary Care Master Class on August 20th and 21st, 2021 at our Plum Health DPC office in Detroit, Michigan and accelerate your growth as a DPC doctor.