Direct Primary Care Elective Rotation Curriculum

Many students and residents aspiring to become direct primary care doctors have reached out and asked for advice on how to write a direct primary care elective rotation curriculum. Writing your own elective rotation curriculum for a month with a direct primary care doctor can be transformational, and it’s a crucial step towards seeing what works in the direct primary care model. I highly encourage all students and residents to look into either writing their own direct primary care elective rotation curriculum or using a template to write their own curriculum.

When I was a third year resident, I wrote my own direct primary care elective rotation curriculum and it was quickly approved by my program director. I traveled out to Kansas and Colorado to shadow some influential direct primary care doctors and it was transformative for my journey to start and grow my own direct primary care practice. I detail that journey in my book, Startup DPC How to Start and Grow Your Direct Primary Care Practice.

Writing a Direct Primary Care Elective Rotation Curriculum: What to Include

When you write a direct primary care elective rotation curriculum, you should include required responsibilities for the elective rotation, like the amount of time you’ll spend shadowing, working with, or learning from a direct primary care doctor.

You should also include goals of the rotation, like being able to differentiate between various payment models for family medicine and to gain experiential knowledge from other practicing physicians in varying payment models.

Further you should include learning objectives, like understanding the concepts of how to write a business plan and learning how to interact with the community as a business owner. There are so many tangible skills to learn, and this is a good place to include those objectives.

Download our Direct Primary Care Elective Rotation Curriculum

If you’d like to download our direct primary care elective rotation curriculum, it can be found as a part of our Startup DPC course on writing a business plan. In my opinion, these two documents go hand in hand.

You Do Not Need an MBA to Start a Successful Direct Primary Care Practice

Do I Need an MBA to Start a Direct Primary Care 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. #StartupDPC

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.

For example, I needed help designing a logo, so I hired a logo designer to help me get this done. That logo designer gets paid a one-time fee, but does not get paid a percentage of my revenue ad infinitum.

If you’re ready to take the next step, pick up a copy of our book, Startup DPC: How to Start and Grow Your Direct Primary Care Practice. Read more after the break.

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 #StartupDPC

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 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

Paul Thomas MD at the Direct Primary Care Summit 2020

This weekend I had an amazing experience participating in the direct primary care (DPC) Summit 2020 with the American Academy of Family Physicians (AAFP). It was a virtual only Summit, but it was still a great time. To be sure, a virtual conference is different, but I was still able to interact with colleagues and help my fellow conference goers in their journey of starting and growing their direct primary care practice. Here’s a photo from the DPC Summit 2019, and one of my presentations therein:

Paul Thomas MD presents at the DPC Summit 2019, pictured here!

AAFP DPC Summit 2020 Student and Resident Track

On Friday night, I was a panelist with Dr. Kenneth Qiu, Dr. Delicia Haynes, and Dr. Kirby Farnsworth as we discussed how we started a direct primary care practice. This content was geared towards students and residents who would like to start a direct primary care practice directly after completing their residency training. Dr. Qiu did a masterful job coordinating this content and moderating three panels in a row.

Dr. Paul Thomas at the DPC Summit 2020 with Dr. Delicia Haynes and Dr. Kirby Farnsworth.

How to build out the direct primary care practice of your dreams!

On Saturday, I gave a standalone presentation on how to build the practice of your dreams, specifically discussing how to build a physical office in which you can practice medicine on your own terms for the benefit of your patients in your community.

I only had 45 minutes allotted to discuss this in-depth and wide-ranging topic, so I had to pare down all of the information I wanted to share to get it under this time limitation. However, if you want to see my full thoughts on this subject, I’ve created a course that guides you through the process of leasing a space, sub-leasing a space, building out an office, working with contractors, working with architects, etc… so that you can build the perfect direct primary care office for yourself and for your patients.

The response to this lecture was tremendous! So many doctors were engaged with the material and they had a ton of questions. I couldn’t answer them all during the event, so I’ll answer a few more here.

How do you find sublets or places to sublease?

To find a place to sublease, the best thing to do is to look around your local market. You need to talk to doctors and different real estate agents and sometimes landlords to find places that are subleasing. If you can lease a small office with a bathroom, that is an ideal situation. But if this space isn’t available in your real estate market, you may have to look around for a sublease. Perhaps a cardiologist in town has an unused exam room that you could sublease. If this is the case, do not violate Stark laws by referring all of your cardiovascular patients to this cardiologist.

When you lease a space, do you pay for the entire build out cost?

Yes, we have done this for our spaces at Plum Health so far. Sometimes, when you sign a lease with a landlord, you can negotiate for tenant allowance or tenant improvement funds. This might be $5 to $20 per square foot or something like that. For example, if you lease out a 500 square foot office and as a part of the 10 year lease agreement you get $10 per square foot of tenant improvement money, you would have $5,000 to invest into the space. I haven’t come across many leases where this is an option, and many entrepreneurs typically invest into building out their own spaces.

The market in my area seems to be saturated with FFS and Urgent Care Options. Should I go to the next town over?

This was a longer question that I paraphrased above. Here’s the full question:

There are no DPC anywhere where I am located. There are many urgent care centers popping up along with FFS primary care offices that have been around for years. Should I stay away from those areas and open in a rural town that has no primary care?

One of the most important things to do when you start a direct primary care practice is to differentiate yourself from the existing market and to meet a previously unmet need in your community with that differentiated product. You could say that our Detroit market had enough options for patients, but we saw it differently. We created a business and a brand at Plum Health DPC that stands out from the rest and that consistently attracts new people who want to become our patients because of our differentiated offerings.

To answer your question directly, if you believe that you can differentiate yourself from the rest of the options in your community, go for it! Be bold and start your DPC practice and meet that previously unmet need. If you don’t think you can compete, go to the next town over.

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 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

Paul Thomas MD and Startup DPC Featured on Physician Estate

This week, Paul Thomas MD and Startup DPC was featured on Physician Estate. Here’s the full interview:

Direct Primary Care vs Traditional Fee-for-Service Medicine

Direct Primary Care Practice vs. Traditional Fee-for-Service. We wanted to know more about DPC practice and how it is different from fee-for-service from the perspective of an experienced DPC doctor. We were lucky enough to have a Q&A interview with Dr. Paul Thomas of Plum Health DPC. Dr. Paul Thomas is a board-certified family medicine physician practicing in Corktown Detroit. His practice is Plum Health DPC, a Direct Primary Care service that is the first of its kind in Detroit and Wayne County.

In this Q&A blog post interview, he will share about his practice, challenges and milestones in his journey, and tips for physicians who are planning to start their own DPC practice. Are you a physician interested in starting your own DPC practice? This blog post might be helpful for you!

On Background

1. Please tell us a bit about your personal story, growing up, and medical training.

• I started volunteering in Detroit for homeless and uninsured folks in 2017. I really love taking care of people, but the further and further I got into my training, the less and less time I spend with my patients. Until I get to the end of my residency, I’m spending 10 or 15 minute per patient, and spending a lot more time charting, writing things in the medical record. I thought this was really unsustainable, I felt burned out–I didn’t want to do that anymore. 

• So I wrote a business plan in the last year of my residency, and I launched my practice, Plum Health DPC. And 4 years later, I’ve been doing really well with the practice–we’ve grown, we’ve hired 2 more doctors and we had a second location. 

2. What made you develop interest in Direct Primary Care? Motivating factors? Did you pursue any formal education/training that focuses on Direct Primary Care? If so, what was it?

• I developed an interest in Direct Primary Care because I felt like it was the only way out of a dysfunctional, industrial complex. I didn’t have any formal training in this, I wrote a business plan, I worked with a friend who started a suit company, of all things to write a business plan.

• I went on a road trip, visited a few mentors across the country who helped me formulate my plans and refine my business plan and make it so that I could develop a thriving practice here in Detroit, Michigan.

About Plum Health – A Direct Primary Care Platform

3. What is Plum Health? As a platform that specializes in Direct Primary Care practice, what is its unique value proposition? Tell us the story behind its creation. 

• In Plum Health, we believe that healthcare should be affordable and accessible for everyone, so we really do our best to lower the cost in Detroit and beyond. We contract with a local imaging vendor, a medication wholesale supplier, etc. to lower the costs of all those things. 

• So if you come in for a lab draw, you might get a TSH for $6, that’s what it costs here. But if you go to a hospital, it might cost you $125. So we really try to reduce the cost of healthcare for people. 

• Our unique value proposition is that we have time for our patients. Because our patients pay a monthly membership to be a part of our practice, we have this nice recurring revenue from our patients. We then get to spend more time with them as an individual–we have 1-hour appointments, and we can really listen to them and take care of them and all their concerns.  

4. Generally, how do you help educate physicians in the US who are interested in starting their own Direct Primary Care practice? Do you provide any services, courses, coaching, etc?

• I’m so glad you asked this. I’ve written 2 books about this. The first is called Direct Primary Care–it focuses on how Direct Primary Care serves people in the greater healthcare ecosystem, how you can lower the cost of healthcare for everyone (medications, labs, imaging, etc.) We also discuss how we’ve done this in an equitable and sustainable way in our hometown of Detroit, Michigan. 

• For the book How to Start Your Direct Primary Care Practice, we’ve had so much success here in Detroit. Because I’ve been a speaker at the American Academy of Family Physicians Direct Primary Care Conference and the Nuts and Bolts Conference in Florida, I’ve had a lot of people reach out to me and asked how we were successful, how we did this. To answer that, I wrote a book–it’s called Start Up DPC, how to start and grow your Direct Primary Care practice. I wrote in step-by-step how to start your Direct Primary Care practice. I’ve got a ton of great feedback on this book! We’ve had a lot of people reach out and say how impactful the book has been for them, and we’ve helped other doctors launch their own practices.

• I’ve been doing consulting throughout this, so people pay me some money each hour that I consult with them, and I’ve also taken everything I’ve learned and put it into some courses on my website https://startupdpc.com. I really walk doctors step-by-step through how to start and grow their practices, and I go beyond just the words, I show you how to do it physically. I show you how to do it online and how to leverage your Facebook page and other social media channels to grow your business etc.

Challenges and Milestones in Starting A Direct Primary Care Practice

5. What are some of the mistakes you made when you were still starting out with your Direct Primary Care practice? If you had to redo the whole journey, what would you do differently?

• The biggest mistake was I was thinking too small, I should have hired a medical assistant sooner. I thought I could do everything by myself, and I could–I could draw blood, count all the lab samples and the meds, I can answer all the phone calls, and I did that for about 450 patients, and I hired a medical assistant. And as soon as I did that, it freed up so much of my time to market the practice and help me grow my business.

• So if I had to redo the whole journey, I would have hired someone sooner. As a business owner you want to control everything, but sometimes you have to delegate and relinquish that control so you can focus on your strengths to help you grow your business. 

6. Share a few very milestones you achieved in your Direct Primary Care journey.

• One of those big milestones was hiring a medical assistant, another doctor to help me lower the cost of healthcare in Detroit. I’m very happy to share it with my partner who is Dr. Raquel Orlich.

• Another milestone for me is getting to 500 patients, and 200 patients for Dr. Raquel, and now she’s over 250 patients. These are the milestones that we celebrate because we’re actively learning the cost for healthcare in our community, we’re helping patients, we’re liberating doctors from the dysfunctional fee-for-service medical industrial complex system. 

7. How do you see Direct Primary Care evolving over the next 5-10 years? How does the political climate and ever so polar political opinions affect the evolution of DPC? 

• I only see Direct Primary Care growing over time because people hate having to deal with their insurance for their basic healthcare needs. It puts up so many barriers between people and our doctors. Direct Primary Care doctors are problem solvers. We go above and beyond to solve problems for our patients and make our healthcare journey easier. So when you have doctors actively working on behalf of patients, it’s only going to grow because patients see value in that kind of work that doctors provide. 

• As for the political climate, or let’s say medicare for all passes, which does not apply for Donald Trump, or presidential candidate Joe Biden at this time, neither of these political parties want to see medicare for all at this point. But let’s say even if it does pass 20 years from now, the United States government will not be able to outlaw elective procedures. Americans will always be able to opt for paying above and beyond for health insurance, etc. 

• In a nutshell, I don’t foresee paying above and beyond your health insurance for better healthcare experiences through Direct Primary Care or concierge medicine. I don’t ever see that being outlawed in the US.

Direct Primary Care vs. Traditional Fee-for-Service

*This section is for patients and doctors that are not yet aware of DPC

8. In a nutshell, what do you think is the major difference of Direct Primary Care practice vs. Traditional fee-for service? 

• The number of patients. Fee-for-service doctors have 2,500 patients a year, and they have to see 1% of their panel each day. So they have to see at least 25 patient visits a day. In our model, we only need 500 patients to have a robust, thriving practice. We make about the same amount of money as a fee-for-service doctor. 

• That being said, I have 5 times fewer patients and 5 times more time for each of those patients. It makes a huge difference.  

9. Why should a patient consider enrolling in a Direct Primary Care practice over the traditional fee-for-service?

• You are going to have 5 times more time with your doctor, you’re going to have your doctor’s mobile number and email address, you’re going to be able to reach out to them whenever you need them and not the other way around. 

• We’re not fitting you into our schedule, we’re making time for you anytime you need us. 

10. If you are explaining about Direct Primary Care to a layman who doesn’t have a medical background, what would be your 2-minute explanation to make him/her understand Direct Primary Care practice?

• We really believe that healthcare should be affordable and accessible for everyone. You should sign up for Direct Primary Care practice if you want to have your doctor’s mobile number and text them anytime you need them. Basically if you want to have a better healthcare experience. 

• My patients have my undivided attention for 20-30 minutes to an hour if they need it. I help them with their medications, etc. We take care of everything. If you want that kind of service for yourself and for your family, we’re happy to help you. We do that to all our patients, we deliver high quality, high value services. 

Favorites

11. Favorite book that talks about Direct Primary Care; and favorite book in general about any topic

• My favorites are the 2 books that I’ve written. Startup DPC and Direct Primary Care: The Cure for Our Broken Healthcare System are available on Amazon. Pick those up, you’ll really understand my ethos, and the ethos of the Direct Primary Care movement. People have a lot of great things to say about them. 

• My favorite book in general about business is Crush It by Gary Vander Truck. If you want to know how to market your business, your Direct Primary Care practice, you can learn a lot from reading Gary V. 

12. As someone who is an advocate of Direct Primary Care practice, what are your favorite resources for Direct Primary Care?

• I would say my website https://startupdpc.com. I really took the time to compile all the resources in the ecosystem and give it to you in a palpable, easy-to-understand, easy-to-digest format. 

13. Favorite bloggers that have the same passion as you when it comes to Direct Primary Care

• I blog a lot about this subject, I haven’t seen anyone “out blog” me, so check out our blog at https://startupdpc.com/blog. See for yourself.  

14. Favorite quote

• “It is not the critic who counts; not the man who points out how the strong man stumbles, or where the doer of deeds could have done them better.” –Theodore Roosevelt

Tips for Physicians Who Are Planning to Start Their Own Direct Primary Care Practice

15. Many physicians find it challenging to start their own Direct Primary Care practice. As someone who’s been in the Direct Primary Care business for quite some time now, what do you think physicians should first do when they are starting out? Any tips and/or strategies you highly recommend?

• I really recommend you read my books because I put them all in there. 

• My biggest tip is that doctors think that when they start their Direct Primary Care practice, it’s for everyone. You ask them who’s your ideal customer and they say “everybody”. But it’s not true. You really have to hammer down and hone in on who your ideal customer is. If you don’t, you’re going to try to serve everyone, and your business is going to fail.

Paul Thomas MD has written two books on Direct Primary Care - both can be found on Amazon, here: Startup DPC and Direct Primary Care.

Should You Offer One-Off Visits?

This question comes up a ton - should you offer one-off visits to those patients interested in an urgent care-type relationship with your clinic?

Here’s a question I came across recently:

So, I'm stepping up to the edge of the pool getting ready to take the plunge, but still struggling with the details.

As has probably gone through the head of virtually everyone who has gone DPC, I'm not sure how well it work in my community.  That said, I'm about to give it a shot and see how it goes.

One thing I've contemplated is whether or not to offer "A la carte" type pricing for people who don't want to actually purchase a monthly membership.  When I've mentioned this to folks doing DPC, I mostly get the advice of "Don't do it.  Too much headache."

I've been warned that it will attract drug-seekers and otherwise annoying/abusive patients.  I've also been warned that it will result in patients expecting to then have the same level of access monthly paying members..i.e. calling for refills, follow up questions, etc. without wanting to pay, making accusations of abandonment if you don't play along, etc.

My biggest worry is that with this option available there may be patients who would otherwise be willing to pay a monthly membership but choose not to due to the al la carte "fee for service" availability.

That said, I feel like I could offer "one off" clinic visits for say $120 or so and still be the cheapest option in my area for people who only go to the doctor when they are sick and thus wouldn't want to join a DPC.  Hard to imagine turning this money away.

Thought I'd through this out to the group and get input on this from folks who have maybe gone down this path previously.

Here’s my response:

At Plum Health, we really try to avoid any one-off type arrangements. When I do offer one-off visits, I charge $200 per visit if they are walking in off the street. For context, our membership is $49/month for adults 18 - 40 years of age. We charge a high rate for the one-off visits so that we don't cheapen the value of the membership for our existing, loyal customers. 

Additionally, if the patient is paying $200 for a visit, why not enroll in the membership for $49 per month? That would give you at least 4 months of great service for the same price. We want to funnel prospective patients into the membership.

I talk about this topic in great detail, as well as many other topics in my most recent book, found here: https://www.startupdpc.com/books

Best of luck!

- Paul 
--
Paul Thomas, MD

Physician with Plum Health DPC

http://www.plumhealthdpc.com/

Finally, we’ve been getting some great feedback from our book, Startup DPC: How to Start and Grow Your Direct Primary Care Practice. Thanks for all the shout outs and support!

-Dr. Paul Thomas with Startup DPC

We’re getting some awesome pics from our fans!! The Startup DPC book has been a huge hit among doctors looking to free themselves from treadmill medicine #startupdpc #DirectPrimaryCare #familymedicine #healthcare https://t.co/YN8WUdm2RN pic.twitter.com/E3AQVCv4Kd

— Paul Thomas, MD (@PlumHealthDPC) June 30, 2020

What is Direct Primary Care? Q & A with Physician Estate

This is Dr. Paul Thomas with Plum Health DPC and Startup DPC. I received a long list of questions about Direct Primary Care from Physician Estate and I'll do my best to answer all of them here!

The Background of Paul Thomas, MD and Plum Health DPC

1. Please tell us a bit about your personal story, growing up, and medical training.

I really answer this fully in my first book, Direct Primary Care: The Cure for Our Broken Healthcare System. But briefly, I started my journey in medicine by volunteering at a local free clinic. I loved working with patients. But, by the end of my residency, I found that I had less and less time with my patients. I needed to find a way to practice medicine on my own terms and for the benefit of my patients.

I also talk about this in my TEDXDetroit talk, here:

2. What made you develop interest in Direct Primary Care? Motivating factors? Did you pursue any formal education/training that focuses on Direct Primary Care? If so, what was it?

By the end of my residency, I was spending less time with my patients, and I didn’t want to participate in or perpetuate the dysfunctional health insurance system of healthcare delivery. So, I wrote a business plan and started my own direct primary care practice, Plum Health DPC in Detroit Michigan.

About Plum Health - A Direct Primary Care Platform

3. What is Plum Health? As a platform that specializes in Direct Primary Care practice, what is its unique value proposition? Tell us the story behind its creation.

Our unique value proposition is the amount of time and the amount of value that we can give to each of our patients. In a fee-for-service system that emphasizes speed and allows doctors and patients to have less time with one another, Plum Health DPC stands out in it’s ability to cultivate the physician-patient relationship.

4. Generally, how do you help educate physicians in the US who are interested in starting their own Direct Primary Care practice? Do you provide any services, courses, coaching, etc? Challenges and Milestones in Your Direct Primary Care Practice

I’ve been a speaker at the AAFP DPC Summit and at the D4PC Foundation Nuts and Bolts Conference. Because of these prominent speaking opportunities, I’ve been sought out by other doctors to help them start and grow their DPC practices. I’ve consulted with individuals and I have some courses and resources on this website to help my aspiring DPC colleagues. I’ve also written the book Startup DPC: How to Start and Grow Your Direct Primary Care Practice, which has helped hundreds of doctors in their direct primary care journey.

5. What are some of the mistakes you made when you were still starting out with your Direct Primary Care practice? If you had to redo the whole journey, what would you do differently?

Early on, I made the mistake of doing everything myself. I should have hired a medical assistant sooner and I should have hired a second doctor sooner. Hiring other people has helped me serve more people in our community with excellent primary care services.

6. Share a few special milestones you achieved in your Direct Primary Care journey.

There are many milestones that we’ve reached along the way. During my journey, I’ve hired people, I’ve built out a larger office in my community dedicated to lowering the cost of health care, and we’ve grown our medical practice to serve more people.

7. How do you see Direct Primary Care evolving over the next 5-10 years? How does the political climate and ever so polar political opinions affect the evolution of DPC?

Direct primary care will continue to grow and thrive as long as direct primary care doctors continue to go above and beyond for their patients. This looks like solving difficult problems for your patients every day.

Direct Primary Care vs. Traditional Fee-for-Service

This section is for patients and doctors that are not yet aware of DPC

8. In a nutshell, what do you think is the major difference of Direct Primary Care practice vs. Traditional fee-for service?

The biggest difference is the time that doctors and patients have together. The next biggest difference is that the doctor is actively trying to solve problems for their patients and lower the cost of health care for their patients.

9. Why should a patient consider enrolling in a Direct Primary Care practice over the traditional fee-for-service?

People choose Plum Health and direct primary care services like Plum Health because they have more time with their doctors and easy access to their physicians via texts, phone, calls, and emails. They also have $0 copays for visits, and they can save 50% to 90% on labs, medications, and imaging services.

10. If you are explaining about Direct Primary Care to a layman who doesn’t have a medical background, what would be your 2-minute explanation to make him/her understand Direct Primary Care practice?

I would tell them something like this (our winning pitch at the Detroit Demo Day, where we won $50,000 for the buildout of our new, larger office in Corktown, Detroit):

What are your Favorite Direct primary Care REsources?

11. Favorite book that talks about Direct Primary Care; and favorite book in general about any topic

Well, my favorite book about direct primary care is my newest book - Startup DPC. One of my favorite books in general is CRUSH IT! by Gary Vaynerchuck.

12. As someone who is an advocate of Direct Primary Care practice, what are your favorite resources for Direct Primary Care?

13. Favorite bloggers that have the same passion as you when it comes to Direct Primary Care 14. Favorite quote

Tips for Physicians Who Are Planning to Start Their Own Direct Primary Care Practice

15. Many physicians find it challenging to start their own Direct Primary Care practice. As someone who’s been in the Direct Primary Care business for quite some time now, what do you think physicians should first do when they are starting out? Any tips and/or strategies you highly recommend?

On Investments

16. Tell us a bit about your investment strategies. Do you invest your savings? If so, what are your favorite asset classes? Do you max out on your retirement accounts? Since you own your practice, do you utilize solo 401k?

Final Thoughts on Direct Primary Care Practice

17. This is an open ended question. Please feel free to share your closing thoughts.

18. For physicians who are looking for great resources on Direct Primary Care - What is the best way for them to get in touch with you?

"Great Sales Funnel Course!" and HIPAA Protected Communications

Direct Primary Care Sales Funnel Course Receives Praise

One of Startup DPC docs recently completed the Sales Funnel Course and had this to say about the experience:

Hi Paul, great sales funnel course! I will start implementing what I learned immediately.  When you set up MailChimp for newsletters, how do you share your subscriber’s data and be HIPAA compliant with your patients? MailChimp doesn’t have a BAA for PHI. Any other recommendations?

Thanks for your insight.

First of all, I’m glad people are enjoying and getting a ton of value out of the Sales Funnel Course. I’ve had several docs talk about how helpful it has been in helping them attract new patients for their direct primary care practices.

Using Email Marketing Platforms to Grow Your Direct Primary Care Practice

Second, I don't put my patients info into MailChimp unless they enroll themselves. If someone goes to my site, they can sign up for my email blasts by putting in their email address online, via a form submission on our website. I’ve synced my MailChimp account with my Plum Health SquareSpace account. Therefore, if anyone submits their email address on my website, they automatically are asked if they’d like to join the email list. If they agree to MailChimp’s terms and conditions, they are then made a part of my email list.

If set up correctly, this is more or less an automated process. I then send out monthly email blasts to those folks. Here’s the form as it appears on our Plum Health DPC website.

This is the site on my Plum Health DPC website where folks can submit their contact information. If they complete this form and agree to MailChimp’s terms of service, we can send them emails whenever we like. We usually send monthly updates.

For my patients, I send them notes via my EMR. There's a function in ATLAS that allows me to send a group email to all of my patients. 

As a side note, I have all of my patients waive my obligation to their HIPAA rights in the contract, which is roughly 7 pages long. That way, I have some protection for any emails, phone calls, or text messages. 

- Dr. Paul Thomas with Startup DPC

Low Cost Tools to Create Excellent Video Content for Your Direct Primary Care Practice

How to Create Excellent Video Content for Your Direct Primary Care Practice

This week, I got a really nice note from a direct primary care colleague. He wanted to know about the tools that I use to create engaging video content for my direct primary care practice. Here’s the ask:

Hey Paul, I hope all is well and that you’re staying safe during this time. You posted your equipment on how you make videos - the computer program, the lighting, the microphone, and the camera that you use to make your videos for Startup DPC and for your practice Plum Health DPC. Can you share that information with me again? I can’t seem to find the post. I want to start making videos and I think these tools and resources will help me to create better videos.

Thank you

There are a ton of great people in the direct primary care movement and I love seeing them succeed in their direct primary care practices. So here it is, the tools that I use to make great video content!

Tools of the Trade

The editing software that I use during my lectures is called Camtasia and it costs $250 - https://www.techsmith.com/store/camtasia. I don't make any money from recommending this product and I recommend it because it's easy to use and low cost. Also, they're based in Lansing Michigan, so a part of my State's economy.

The camera that I use is found on Amazon and it's a Logitech C920S - it costs about $225 and it's worth every penny because the video quality is just so damn good. Here's a video with the basic MacBook Air webcam (super grainy, almost distractingly so). Here's a video with the Logitech C920S HD Webcam that shoots in 1080p: perfectly focused and crystal clear.

The microphone that I use can be found on Amazon, and it's called a Blue Yeti. It costs about $129 if you click over to the basic (silver) color package. The blue version of the Blue Yeti is $146. I don't know why I can't link directly to this lower cost microphone, but it's there for less expensive if you click over to the silver one.

So for right around $600, you can have everything that you need to create excellent content.

Lighting Your Video Perfectly

Now, if you want to kick it up a notch, you can use a simple ring light to give you the perfect lighting in any environment. It's about $60 or $65 on Amazon.

A ring light is great for shooting in situations where lighting is less than ideal. I shoot most of my videos in my office because I get great lighting - there's a large window that faces our front desk, so I just sit at the front desk or stand behind my front desk and enjoy perfect lighting.

A few things to note about this video - the sound quality isn't as good because the camera/microphone combo that is my iPhone is being held 8 feet away from my mouth, so it sounds echo-y. Also, the video quality isn't nearly as good as my other videos shot in 1080p using my Logitech C920S.

So in daytime situations at my office, my lighting is perfect. But, if I'm in another room in my office, or filming at home in my home office, my lighting isn't very good as is. Therefore, I bought a ring light to give me excellent lighting wherever I may be. Here's what that ring light looks like in my dining room and here’s what the ring light looks like in my home office.

Here's an example of mediocre lighting, I was at Ford Field where the Detroit Lions play for a Men’s Health event. You see how the light source (big windows) are on the right side of the screen? And do you see how that illuminates the left side of my face, but leaves the right side of my face in shadow? This is an example of less-than-ideal lighting.

Here's another video with crappy lighting - the overhead fluorescent lights illuminate my forehead and leave my chin dark. Also, no microphone so bad sound quality, and no HD camera, so kind of a grainy video.

However, if that same office with the same camera location is shot during the day, you can see how much better the lighting can be.

With a ring light, you can have perfect lighting any time, any where. So it's a reasonable investment if you're filming in a location where you know the lighting isn't great - for example if you're shooting in a low-light environment or in a room lit by overhead fluorescent lights.

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 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