How to Hire a Doctor for Your Direct Primary Care Practice

How to Hire a Doctor for Your Direct Primary Care Practice

As a Direct Primary Care doctor, you started an amazing practice, and you’ve worked so hard up to this point to build out your work flows and to grow your panel, optimize revenue collection, and train your staff. You’ve done such a great job that, now, you’ve got a waiting list! Congratulations! People have heard great things about your clinic and they’re ready to signup!

Just one little problem - you’re fully booked and you can’t take on any more patients, and you really would like to go on a care-free vacation. Sounds like it’s time to hire another doctor!

Hiring a doctor for your direct primary care practice can be challenging as it involves several important steps. Here's a general guide to help you through the process:

1. Determine your needs: Assess your practice's requirements to identify the specific role and responsibilities you want the doctor to fulfill. Consider factors such as patient load, personality fit, and any additional skills or expertise you desire. The biggest thing you need to assess is this: does this person believe what I believe? Are they down for the mission of our clinic? Because you don’t just want a doctor, you want the doctor. You need to make sure their heart is in the right place, and honestly, the rest will follow.

2. Create a job description: Develop a comprehensive job description that outlines the qualifications, responsibilities, and expectations for the doctor position. Include details about the direct primary care model, your practice's mission, vision, and values, and any unique aspects of your approach.

3. Write a contract or have a lawyer help you write a contract. This is a job and also a legal obligation - having everything in writing and signed by both parties is crucial to getting what you want and showing the new doctor what to expect. We share our sample contract in our Startup DPC course, on how to hire a doctor!

4. Advertise the position: Utilize various channels to attract potential candidates. Post the job description on online job boards, medical association websites, social media platforms, and consider reaching out to local medical schools or residency programs. Networking within the medical community may also help you find suitable candidates. If you’ve built a strong social media ground game for your direct primary care practice, chances are there are other doctors on the outside looking in and wanting to join you! It may take one, well-written social media post to find the perfect practice partner. Additionally, your alumni reunion activities for your medical school may be a great place to find another doctor or your residency program - if you’re 3, 5, 7, or 10 years out, you may have a colleague who is looking for a change of pace or for that DPC work-life balance.

5. Review applications and conduct interviews: Carefully review the applications you receive, considering the candidates' qualifications, experience, and compatibility with your practice's values. Shortlist the most promising candidates and invite them for interviews. Conduct thorough interviews to assess their clinical skills, communication abilities, and alignment with your practice's philosophy. You will probably want to have your medical assistant interview the prospective person as well, and you’ll want to ask the same questions to each candidate to ensure a fair and balanced interview process.

6. Check references: Contact the references provided by the candidates to gain insight into their past performance, work ethic, and professionalism. It's important to verify the information provided in their application and ensure they have a good reputation. A great question to ask an old colleague - “how did you feel working with this person?” Another good question: “would you want this doctor caring for your spouse, kids, or parents?”

7. Observe clinical skills: Consider arranging a practical assessment to evaluate the candidates' clinical skills. This can involve having them perform a mock patient consultation or observe them during a real patient encounter. Assess their ability to provide comprehensive care and establish a good rapport with patients. At Plum Health, we invite our prospective doctors to spend a day or a half day in our clinic to work with us as we see patients. We get a way better understanding of their demeanor and presence in the exam room.

8. Assess cultural fit: Evaluate the candidate's compatibility with your practice's culture and values. Direct primary care often emphasizes strong doctor-patient relationships, personalized care, and a patient-centric approach. Look for candidates who align with these principles and demonstrate a genuine interest in the direct primary care model.

9. Offer and negotiate: Once you've identified the most suitable candidate, extend a formal job offer that includes details about compensation, benefits, working hours, and any specific terms or conditions (this is all in your contract ideally!). Be prepared to negotiate certain aspects, such as salary or benefits, if necessary.

10. Onboarding and orientation: Once the doctor has accepted the offer, facilitate a smooth onboarding process. Provide them with any necessary paperwork, introduce them to your existing staff, familiarize them with your practice's policies and procedures, and provide any training or orientation required.

11. Ongoing support and development: Support the doctor's professional growth and development by offering opportunities for continuing medical education, attending conferences, or participating in relevant workshops. Encourage open communication and provide a supportive environment that enables them to excel in their role. With our current doctors, we have helped them to get board certified in obesity medicine, shadow other physicians where they have skill deficits, invite speakers for lunch and learns, and send them to exciting conferences! If you challenge your team mates to bring out the best in them, they will bring their best to the office and to patient care.

12. Start your direct primary care practice in a desirable area! I know this might be a tough pill to swallow, but if you’re in rural community or a community that doesn’t have the resources that support family life (good schools, parks, museums, sports teams, and other enriching activities), you may have a harder time than typical finding great doctors. For us, in Metro Detroit, there are a lot of resources and therefore a lot of talented people in the area - we are blessed to be surrounded by great institutions that attract and retain great talent.

Remember, this guide provides a general framework, and you may need to adapt it based on your specific requirements. Consulting with legal and healthcare professionals in your state can also help ensure compliance with any applicable laws or regulations.

Thanks for reading, and happy hiring!!!

Again, if you want our sample contract and more nitty gritty on this topic, check out our “Hire a Doctor Startup DPC course”, here!

-Dr. Paul Thomas with Plum Health DPC in Detroit, Michigan

What Payroll Option Should I use for my Direct Primary Care Practice?

Payroll for your direct primary care practice can be scary - for most doctors who start a direct primary care practice, this is the first time paying themselves and it’s their first time paying employees.

But, don’t be scared any more! By the time you finish this blog post, you will have a good idea of how to pay your employees in a reasonably easy way.

All the options

There are several payroll options available for small business owners, including:

1. Manual Payroll: This involves calculating and processing payroll manually using spreadsheets or paper-based systems. While this option is low-cost, it can be time-consuming and prone to errors. I strongly recommend against doing this. Your time is WAY better spent taking care of patients or growing the business. Unless you have a background in accounting, do not do this.

2. Payroll Software: Payroll software can automate the payroll process, including calculating wages, taxes, and deductions. There are several software options available, ranging from simple and low-cost solutions to more advanced platforms with additional features such as time-tracking and benefits administration.

   One example of a payroll software is Gusto. Gusto offers a cloud-based payroll platform that automates the payroll process. It includes features such as direct deposit, tax calculations, and benefit administration. Gusto also offers time-tracking and HR features, such as onboarding and document management. Small business owners can choose from several pricing plans based on the number of employees and the features they need. Payroll software like Gusto is a good option for small businesses that want to streamline their payroll process and have more control over the payroll function.

3. Online Payroll Services: Online payroll services provide a cloud-based platform for managing payroll. These services often offer features such as direct deposit, tax filing, and time-tracking. Online payroll services are typically easy to use and affordable, making them a popular choice for small businesses.

   An example of an online payroll service is ADP. ADP offers a cloud-based payroll platform that provides payroll processing, tax filing, and compliance management. ADP also offers HR features such as time and attendance tracking, employee benefits, and talent management. Small business owners can choose from several pricing plans based on the number of employees and the features they need. Online payroll services like ADP are a good option for small businesses that want a simple and easy-to-use payroll solution, without having to invest in additional software or hardware.

   Options 2 and 3 have some overlap because Gusto can be completed online (without downloading a software suite). Other companies that offer payroll software include QuickBooks, PayChex, Xero, and others.

4. Accountant or Bookkeeper: Small business owners can also outsource payroll to an accountant or bookkeeper. These professionals can handle all aspects of payroll processing, including calculating wages, taxes, and deductions. While this option can be more expensive than other options, it can provide peace of mind and ensure compliance with tax laws and regulations.

5. Professional Employer Organizations (PEOs): PEOs are third-party companies that manage HR and payroll functions for small businesses. They offer a range of services, including payroll processing, benefits administration, and compliance management. PEOs can be a good option for small businesses that need comprehensive HR services. If you want to completely outsource payroll and benefits, you’d use an option like this. i don’t know any DPC doctor who uses something like this, as larger businesses would use this option.

It's important for direct primary care doctors to consider their specific needs and budget when selecting a payroll option. They should also consult with a financial professional or tax expert to ensure compliance with tax laws and regulations.

What we use at Plum Health DPC for Payroll

When I started my DPC practice and hired my first employee, I had a really hard time with this. It was more of a mental barrier than anything. I ended up picking Gusto because they have a really nice user experience/design on their website.

I ran payroll for a year using this, but my account found that Gusto was NOT paying my taxes accurately, so we had to put some extra money in at the end of the year. After discovering this, we switched to “RunPayroll”, an online-based platform. I now submit payroll via RunPayroll and my accountant checks on it quarterly.

I pay $62 monthly for accounting, $250 quarterly to my accountant for them to review my books and make sure that all of my expenses are categorized perfectly, and about $1,800 annually for tax preparation for myself and for my business.

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.

When you take an owner’s draw, you should set aside 40% of that owner’s draw for taxes. You will likely pay 25% to 35% of your Net Operating Income in taxes, so be mindful of these numbers. Your accountant should be able to calculate the amount of taxes that you need to pay each quarter.

With quarterly income taxes, you will mail up to three checks to your city, state, and the federal government from the money you make during that period. Here in Detroit, Michigan, we have city taxes paid each quarter (about $125) and state taxes paid each quarter (maybe $1,250). This is usually an estimate. If you over estimate, you could get money back during tax time or have a small tax bill. If you under estimate, you could owe a larger balance during tax time.

I hope this was helpful, and best of luck with your DPC practice!

- Dr. Paul Thomas with Plum Health DPC in Detroit, Michigan.

Key Performance Indicators for your Direct Primary Care Practice

Key Performance Indicators for your Direct Primary Care Practice

Key Performance Indicators or KPIs are the important markers for your success or failure in direct primary care or any business for that matter.

If you have satisfied patients, that’s great - but can you measure patient satisfaction? If you are managing your diabetic patients with excellent care, that’s good, but can you measure the average a1c in your practice? What about total revenue and percentage of revenue collected?

When you start a DPC practice, you may not think about these KPIs at all, but as you grow and become more sophisticated in your DPC practice, these KPIs may become more and more important, especially if your aim is to scale your business or evaluate the effectiveness of a new hire, either a physician or medical assistant.

Just as you take vital signs from your patient to measure their health, so too can you take KPIs from your business to measure the health of your practice.

The most important Key Performance Indicators (KPIs) for Direct Primary Care (DPC) practices can include:

1. Patient satisfaction: Measured through surveys or interviews, this KPI assesses how satisfied patients are with the quality of care and services provided by the DPC practice.

2. Retention rate: This KPI measures the percentage of patients who remain with the DPC practice over a given period of time.

3. Revenue: This KPI measures the income generated by the DPC practice, which can include membership fees, additional services, and lab tests.

4. Utilization rate: This KPI measures the number of patients who use the DPC practice's services, such as office visits and telemedicine consultations.

5. Quality of care: This KPI measures the quality of care provided by the DPC practice, including clinical outcomes, patient safety, and adherence to best practices.

6. Staff satisfaction: It's important to measure the satisfaction of the staff with their job in order to keep them motivated and engaged.

7. Net Promoter Score (NPS): This KPI measures the likelihood of patients to recommend the DPC practice to others.

Why Direct Primary Care Practices Fail

Starting a direct primary care (DPC) practice can be a rewarding and fulfilling career choice for doctors, but it is not without its challenges. In this blog post, we'll explore some of the common reasons why DPC practices may struggle to get off the ground or fail to grow.

1. Lack of understanding of the DPC model

   • One of the biggest obstacles for DPC practices is a lack of understanding of the model among both patients and other healthcare providers.

   • Many people are not familiar with the concept of DPC, which operates outside of the traditional insurance-based system and instead relies on direct payment from patients. This can make it difficult to attract patients and build a sustainable practice.

   • In many communities, your DPC practice might be the first of its kind, which means that you have to teach everyone about what direct primary care is and why it matters. This can be a heavy lift!

2. Limited marketing and outreach efforts

   • Marketing and outreach are essential for any business, but they are particularly important for DPC practices that operate outside of the traditional healthcare system.

   • Without a strong marketing strategy, it can be difficult to generate awareness of your practice and attract new patients.

   • Specifically, your name is NOT on the back of anyone’s insurance card, so you will not get guaranteed business and you certainly can’t guarantee referrals.

   • If you’re a younger doctor and not established in the community as a trusted physician, you’ll have to lean heavily on social media or leverage traditional media. I teach these skills in our sales funnel course, here.

3. Failure to differentiate from other DPC practices

   • As the DPC model becomes more popular, the number of DPC practices is increasing. This can make it difficult for new practices to stand out and attract patients.

   • To be successful, it's important to differentiate your practice from others by offering unique services or a unique approach to patient care.

   • Even though you’re a primary care physician, it can be good to have a specific skill that you’re better at than any other physician in your community. Are you great with OMT? Great with Botox? Do you have a stellar grasp of functional medicine? Are you fantastic at helping patients lose weight? Or can you help patients reverse their diabetes?

4. Poor financial management

   • Starting a new business is always a financial risk, and DPC practices are no exception. Many DPC practices struggle with financial management, often due to a lack of understanding of how to price their services or how to manage cash flow.

   • It's important to have a solid understanding of financial management and to seek out professional guidance when needed.

   • It is important to note that you should focus on your strengths and delegate your weaknesses. For a lot of doctors, they process their business transactions via Quickbooks and have their accountant review those transactions monthly or quarterly. Many doctors also rely on an accountant for payroll. This is okay! It’s good to delegate these tasks that slow you down to someone who can do them quickly and seamlessly.

5. Lack of support from other healthcare providers

   • Many DPC practices struggle to gain support from other healthcare providers, such as specialists or hospitals.

   • This can make it difficult for DPC doctors to provide comprehensive care for their patients and can limit the growth of the practice.

   • For example, if you’re in a small town and your local hospital won’t give a cash price for imaging services, it can be difficult to save money/provide value for your patients in the community.

In conclusion, starting and growing a DPC practice is a significant undertaking that requires careful planning, a solid understanding of the DPC model, and a willingness to overcome challenges. By understanding the common reasons why DPC practices fail, doctors can be better equipped to navigate the unique challenges of this model and build a successful and sustainable practice.

That’s why I strongly recommend our most popular course, our How to Write a Business Plan for your Direct Primary Care practice course - it helps you avoid many of the above pitfalls and it can help to ensure that you have the best chance possible at a successful Direct Primary Care practice!

Good luck, and take action today!

-Dr. Paul Thomas with Startup DPC

Making Donations as a Direct Primary Care Practice

Making donations as a direct primary care practice

This year, we made many donations to local charities in our community, from $100 to $1,000, gifts can be impactful and go a long way, especially in a small town or a close-knit community. As physicians, we have an obligation to give back, to enrich the lives of others. Some of my favorite categories to give to include health and wellness, children and families, and recreational activities.

A shout out from a company that we donated to this year.

For your direct primary care practice, donating to a local charity can build good will for your practice in several ways. First, it demonstrates that your DPC practice is invested in the community and cares about the well-being of its residents. This can help to create a positive image for your practice and your physicians and improve your overall reputation.

Additionally, by supporting a local charity, your DPC practice may be able to build relationships with community members who may become customers or advocates for the business. Even if the folks at the charity don’t sign up for your practice, they will likely spread the good word about your practice to the people that they serve.

Finally, it can also show employees that your DPC practice is socially responsible and that you care about making a positive impact. This can help to boost employee morale and engagement. It’s a great way to boost engagement to work with your teammates, physicians, and staff to pick a local charity that you want to support. You could have everyone chip in and provide a match in addition to a baseline gift.

Good luck with your DPC practice, and happy giving!

-Paul Thomas, MD with Startup DPC

Our Most Popular Startup DPC Courses

Direct primary care (DPC) is an alternative model of primary care that is gaining popularity across the United States. It emphasizes a personalized, patient-centered approach to care and eliminates the need for insurance. However, starting a DPC practice can be challenging. That's why we've developed multiple courses to help you along the way.

Our first most popular course, "Writing a Business Plan for a Direct Primary Care Practice," provides you with the tools and knowledge necessary to create a comprehensive and effective business plan. This includes understanding the DPC model, financial management, and how to attract patients to your practice.

Our second most popular course, "Attracting Patients to Your Direct Primary Care Practice," focuses on marketing strategies for DPC practices. It covers topics such as building a website, social media marketing, and community outreach.

Both of our courses are designed to help you navigate the challenges of starting a DPC practice and provide you with the knowledge and skills necessary to succeed.

Our courses are designed for doctors who are interested in starting a DPC practice, or for those who are looking to grow and improve an existing practice. They cover the most important aspects of starting a DPC practice, from writing a business plan to attracting patients.

We understand that starting a DPC practice can be a daunting task, but with the right knowledge and skills, it can be a successful and rewarding experience. Our courses are designed to give you the tools and support you need to achieve your goals.

If you're interested in starting a DPC practice or want to take your existing practice to the next level, our courses are a great place to start. Sign up today and take the first step towards success.

We are especially happy when we get feed back and reviews like this one:

What are the biggest challenges to starting a Direct Primary Care Practice?

The Biggest Challenges when Starting a Direct Primary Care practice

There are several challenges that doctors may face when starting a direct primary care practice. These may include:

1. Financial risks: Starting a new business always carries some financial risk, and this can be particularly true for direct primary care practices. These practices are often small, and may not have the financial cushion that larger practices have.

2. Marketing and outreach: Direct primary care practices may have a harder time getting the word out about their services, as they are not affiliated with a larger hospital or health system. Doctors may need to be proactive about marketing their practice in order to attract patients.

3. Legal and regulatory issues: Direct primary care practices operate outside of the traditional insurance model, which can create some legal and regulatory challenges. Doctors may need to be familiar with state and federal laws governing the practice of medicine, as well as any additional regulations that apply to direct primary care practices.

4. Managing patients' expectations: Some patients may be unfamiliar with the direct primary care model, and may have expectations that are not consistent with how these practices operate. Doctors may need to spend time educating patients about the benefits of direct primary care and how it differs from traditional primary care.

How to Overcome These Challenges

Fortunately, all of these challenges are manageable and can be overcome with the right mindset and the right tools. Here are a few ways that doctors can address the challenges of starting a direct primary care practice:

1. Seek out resources and support: There are a number of organizations and groups that offer support to doctors starting direct primary care practices. These may include professional associations, business development organizations, and other resources. We’re glad that you’re using Startup DPC as one of those resources! When it comes to reaching out to patients, take a look at our course on attracting new members, here.

2. Carefully plan and budget: It is important to carefully plan and budget when starting a new business, and this is especially true for direct primary care practices. Doctors should have a clear idea of their financial needs and how they will cover them. I would work with another direct primary care doctor or another local business person in your community - have them review your business plan! We created a business plan course as a part of our Startup DPC resources, because doctors don’t often have experience writing a business plan or creating a clinic budget. This is one of our top resources on our site and our business plan course includes a sample budget!

3. Educate patients: It is important to educate patients about the direct primary care model and how it differs from traditional primary care. This may involve explaining the benefits of the model, such as longer appointment times and more personalized care. If you try to do this on a one-on-one scale, this will be difficult. But, if you leverage tools like YouTube or a great website, your patients can watch videos and read blog posts on your site to educate themselves. Make the type of service that you provide in your practice clear on your website. For an example of what this might look like, check out our clinic’s FAQ or Frequently Asked Questions page. We have media interviews, YouTube videos, and written content to explain our services clearly.

4. Stay up to date on legal and regulatory issues: It is important for doctors to stay up to date on state and federal laws and regulations that apply to the practice of medicine, as well as any additional regulations that apply to direct primary care practices. This may involve seeking out legal or regulatory guidance from professional associations or other resources.

Thanks for reading, and best of luck with your DPC practice!

-Paul Thomas, MD with Plum Health DPC

P.S. Our direct primary care practice, Plum Health DPC, recently celebrated SIX YEARS in businesses - I love teaching other doctors how we’ve been so successful at our DPC practice in Detroit. I sincerely wish you the same or greater success - we need excellent doctors like you to create value for patients and create a better health care system.

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Building Your Personal Brand as a Direct Primary Care Doctor

As a direct primary care (DPC) doctor, your personal brand is an important part of your professional identity. It helps to set you apart from other family medicine doctors, urgent care centers, and hospital systems in your area, and can attract new patients to your practice. Here are some tips for building and promoting your personal brand:

1. Define your unique value proposition: What makes you different from other DPC doctors? What are your areas of expertise, and how do you approach patient care differently? By identifying your unique value proposition, you can better communicate the benefits of your practice to potential patients.

2. Develop a strong online presence: In today's digital age, it's essential to have an online presence that showcases your expertise and personality. This can include a website, blog, and social media profiles. Be sure to regularly update your online profiles with relevant and engaging content, and consider using SEO techniques to increase your visibility.

3. Engage with your community: Building relationships with your patients and other healthcare professionals in your community can help to establish your personal brand and reputation. Consider speaking at local events, joining professional organizations, or volunteering your time and expertise to organizations in need.

4. Utilize patient testimonials: Patient testimonials can be a powerful way to showcase the value of your DPC practice. Encourage satisfied patients to share their experiences online, and consider featuring these testimonials on your website or social media profiles.

By following these tips, you can effectively build and promote your personal brand as a DPC doctor. This can help to attract new patients and establish your reputation as a trusted and competent physician.

Marketing Your Direct Primary Care Practice

how to market your direct primary care practice

Today I got a wonderful email from a 3rd year resident who wants to start a DPC practice right out of residency. This is commendable! and echoes what I did as a doctor starting a DPC right after residency completion.

He took our Startup DPC course on Writing a Business Plan and his big ask was as follows: “I wrote this long piece of content, what do you think?”

Overall, the content he wrote was good! It explained his ethos and the ethos of his clinic. But, I told him that one piece of content doesn’t move the needle. I asked him:

“can you consistently make a new piece of content each week, every week, for 5 years? That's the real question. I usually spend about 1 hour each week creating a piece of content to support my DPC practice. This consistency is what draws new members to our practice. It's nice to have a short video or blog post that explains your ethos, but can you create a new piece of content each week?”

How to consistently create content

The best way to consistently create content is to take photos of the work you do in your clinic and to take photos of the work you do in the community. Family photos and hyperlocal content does well also.

You should always be thinking about content creation and trying to capture the moments that visually explain what you do in your DPC practice and how you do it and what it means for the community. After all, a picture is worth a thousand words!

Now, take those pictures, add a caption and post them to your favorite social media channels. I use Facebook, Instagram, LinkedIn, and TikTok most often, in that order. If you can create an engaging piece of content every month, you will have great success with your marketing efforts for your Direct Primary Care practice.

Examples from Plum HEalth DPC

Here are some examples from my business, Plum Health DPC, from the last 4 months of 2022: 

6 years in business: https://www.instagram.com/p/Cmt81PZL3JB/

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Influenza A updates: https://www.instagram.com/p/CmXKf6OvMsu/

House call medicine: https://www.instagram.com/p/ClWl_TrvCC3/ 

Passing of a community physician, friend, and mentor: https://www.instagram.com/p/ClHXhYXvSBa/

Volunteering at a health fair: https://www.instagram.com/p/CjdM4ytL-g3/ 

Teaching other physicians about DPC: https://www.instagram.com/p/CjYJKr_L3Ka/ 

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Talking about healthy foods in Detroit: https://www.instagram.com/p/CjBfbA0P7qz/ 

Laceration repair: https://www.instagram.com/p/CiA-KN6O7Or/

Here are a few more blog post ideas for your direct primary care practice:

1. The benefits of direct primary care for patients

2. Why you decided to start your direct primary care practice

3. The differences between direct primary care and traditional primary care

4. The role of technology in direct primary care (texting patients, emailing patients, video chats with patients)

5. The importance of preventive care in direct primary care (how you have more time to address preventive medicine issues)

6. Direct primary care and the opioid crisis (how you can help your patients manage pain more effectively with multiple modalities, rather than with a pill)

7. Direct primary care and mental health

8. The impact of direct primary care on healthcare costs

9. The future of direct primary care

10. Success stories from patients in a direct primary care practice

Good luck! and keep writing! It helps to keep your audience engaged and it helps to grow your practice when your community knows about you and your ethos.

-Dr. Paul Thomas with Startup DPC

You Have a Business When You Have Your First Customer

What Does it Take to Start a Business?

This week, a friend asked about next steps for starting a new direct primary care business.

For smart people who’ve never started their own business, people like young doctors, young lawyers, or young dentists, graduating from medical school or professional school and entering the work force, it can feel like the only option for you is to get hired by a big firm or to join an existing practice.

But, you have to know that you can start your own business - and that’s the point of this blog post!

So how do you know when you have a business? When someone tells you that they want to pay you, yes you directly for your services, you have a business. For example, if a neighbor lady asks your son or daughter to mow their lawn, your child has a business. If that same neighbor wants to hire you as their doctor, you now have a business.

In short, you have a business when you have your first customer.

You Have a Business When You Have Your First Customer

Now that we know what makes a business, how do you capitalize on that business? Meaning, how do you legally accept payments from someone as a business, and not as an individual?

1.) Register for a PLLC - your PLLC can be anything, ours is "PLUM HEALTH PLLC" but we're doing business as (dba) Plum Health DPC. You could be Fred’s PLLC and dba "Smart Street Health", or Karl’s Dad's PLLC and dba Cool Dad DPC etc... The PLLC tells the state government that you have a business. Here in Michigan, we register PLLC’s, but it may be different in your state.

2.) Get an EIN from your accountant - once you register your PLLC, get the EIN from your accountant. This is a unique number that is essentially a social security number for your business. You need it to open any major accounts, including a bank account. From the IRS:

An employer identification number (EIN) is a nine-digit number assigned by the IRS. It's used to identify the tax accounts of employers and certain others who have no employees. The IRS uses the number to identify taxpayers who are required to file various business tax returns.

3.) Set up a bank account! I started mine with $90 that I had in my pocket:

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4.) Deliver services - this could be refilling a medication, performing a physical exam, performing a Beck’s Depression Inventory, or giving a joint injection. Never underestimate how much value you can provide for patients with your brain and your stethoscope. As your company grows and as you refine your services, you’ll be offering more services and broader services. But for now, focus on getting started rather than having everything that you could possibly need to start.

As an example, I didn’t have an office when I first started - I started by making house calls for the first 2 months of my business. I also didn’t have an EKG machine when I started, but I bought one within 3 months of starting. I didn’t have a spirometer when I started, but I bought one within 5 months of running the business. As you get more revenue, you can use that extra revenue to make your services more robust.

5.) Track payments. This could be as simple as a spreadsheet with a Microsoft product or a Google Doc spread sheet, or it could be a more sophisticated product like QuickBooks or FreshBooks. I started during my first two months using Microsoft Excel to track revenue and expenses, but it was tedious! I quickly switched over to QuickBooks and I’ve never looked back. Often times, these companies will offer a free 30-day trial or a discounted fee for the first 3 months - it makes taking the leap easier. If you hate the service or the product interface, you can always switch companies!

NOW GET OUT THERE AND GET MORE CUSTOMERS.

Have a great weekend,

- Paul

P.S. If you enjoyed learning this material and if you want to take the next step, please check out the Startup DPC book - there’s a step-by-step guide on how to start your direct primary care practice in the book

Additionally, check out the Business Plan Course where I take a deep dive and show you how to write a business plan that will help you grow your direct primary care practice, starting with a written foundation.