Direct Primary Care FAQ

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How Does Direct Primary Care Make Sense from a Numbers Perspective?

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How Does Direct Primary Care Make Sense from a Numbers Perspective?

Lots of people want to know how direct primary care makes sense for doctors from a numbers and earnings perspective. This came up on Twitter today and I was mentioned in one of the responses. Here’s the original question:

I’ve been trying to wrap my head around how DTC healthcare can make $ bc the margins are low. The only way it makes sense to me is if you expect low utilization of services, whereby an ongoing retainer (subscription) is not redeemed often or pt requires very little management.

I responded with the following:

we use a membership model for health care - we take care of about 450 patients per doctor and charge about $60 monthly. A family doctor can make a typical salary if they keep their overhead low. I love DPC and we’re able to serve an HPSA in SW Detroit with our clinic

I added the following:

I have about 450 patients - I see my patients 3 - 4 times each year on average. I see about 4 - 8 patients in a typical work day. Our #PlumHealth clinic is in SW Detroit and we serve an underserved community with affordable and accessible healthcare #directprimarycare #detroit

Thanks for reading and watching, and have a great day.

-Paul Thomas, MD with Startup DPC

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Dr. Paul Thomas at Pearls for Primary Care Conference

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Dr. Paul Thomas at Pearls for Primary Care Conference

Today, Friday September 30th 2022, I was invited to give a presentation on Direct Primary Care for my family medicine residency program. It is a great honor to be invited to this conference to speak about Direct Primary Care and my practice, Plum Health DPC.

This was a great day of lectures and learning and it was truly a privilege to be invited as a speaker in this environment. My talk focused on the Direct Primary Care model. We went through the following learning objectives:

  • Define and understand direct primary care as a financial payment model for primary care delivery

  • Discuss the details of the direct primary care model for physicians and for patients

  • Highlight the growing number of direct primary care doctors in Michigan and why more physicians are choosing the direct primary care model

  • Demonstrate how to start and grow a direct primary care practice in Michigan

There are many challenges in our current fee-for-service system. The biggest challenge being that doctors and patients don’t have enough time together to fully address the health concerns of the patient. This can lead to burnout and a less-than-fulfilling practice of medicine.

The direct primary care model helps patients by lowering the cost of care and allowing for doctors to have more time with their patients to build meaningful relationships and address concerns fully. These trusting relationships can lead to better health outcomes as doctors can spend more time on motivational interviewing to help patients lose weight or taking the time to discuss the pros and cons for vaccines and helping people protect themselves from vaccine-preventible diseases.

Oakwood Annapolis Family Medicine Residents Who Are Direct Primary Care Doctors

Interestingly, several Oakwood Annapolis Family Medicine Residents have taken the leap to start or grow their own direct primary care practices. I have had the great privilege of consulting with some of these doctors and I am always rooting for their success - I believe strongly in the direct primary care model, and the ability of the model to support independent practice and uplift the doctor-patient relationship.

That being said, my residency colleagues who are now in a Direct Primary Care practice include:


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What Makes a Great Domain Name for a Direct Primary Care Practice?

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What Makes a Great Domain Name for a Direct Primary Care Practice?

When you start a business, you need to have a great brand name that’s easy to pronounce, easy to spell, easy to type, and easy to find online.

You don’t want to pick something so common that it will be confused for another brand. For example, don’t pick Apple Clinic or Apple Health - there’s a lot of “Apple”s out there - Apple computers, Apple records, Fuji Apples, Granny Smith Apples, etc…

You also don’t want to pick something that is so uncommon as to be confusing or so esoteric that only a few people will understand. For example, “Salus Health” might be cool if you’re a Latin Scholar, but for the average person, they may have a hard time pronouncing, remembering, or spelling this name.

I recently took a course on improving my presence online, and they had this great table for what makes a great domain name for your direct primary care practice.

Here’s a handy guide to helping you pick a great domain name for your direct primary care practice.

For us, I’ll break down the pros and cons of using “PlumHealthDPC.com” for our business.

  1. Easy to type

    • Yes, PlumHealthDPC.com is relatively easy to type - there are about 13 letters

    • I would have preferred PlumHealth.com, but that domain was already taken

    • The idea here is to keep it simple, “DPC” is hard to communicate over the phone, so in general I would avoid including “DPC” in the name

    • Better domains for our practice would have been “PlumMedical.com” or “PlumClinic.com”

  2. Includes Keywords

    • Our name includes “Health” so that’s a plus

    • We could have been “Detroit Primary Care Clinic” or “DetroitDirectCare.com” but these get a little too long, and I don’t want to be confined to Detroit only - I would like to expand at some point beyond Detroit, so I don’t want to use “Detroit” in our name

  3. Available online and in real life

    • The great thing about Plum Health DPC is that it’s available as a business name and it’s available as a web domain at www.PlumHealthDPC.com

    • We registered our LLC as Plum Health DPC

    • There are no other companies nationwide called Plum Health

    • There is a local Plum Market, but at the time that we started, it had no locations in Detroit or Wayne County

  4. Reflects your type of business

    • Yes, Plum Health DPC reflects our type of busines

    • BUT not everyone knows what DPC or Direct Primary Care is

    • People generally understand that we’re a health care company, clinic, or primary care office by our name

  5. Protects your brand

    • In addition to PlumHealthDPC.com, we bought PlumHealthDetroit.com, which redirects to the former web address

    • So, if we’re on the phone with a prospective patient and they can’t understand “DPC”, we tell them to go to PlumHealthDetroit.com

I hope this helps as you brain storm your brand name and domain name!

-Dr. Paul Thomas with Plum Health DPC and Startup DPC


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How Long do Patients Stay at Your Direct Primary Care Practice?

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How Long do Patients Stay at Your Direct Primary Care Practice?

This week, we had a great question from one of our business analysts about the length of membership at Plum Health DPC. He wanted to know how long patients stay with our practice?

This is a difficult question to answer as our relationships with patients are ongoing - people are signing up with us this month who may stay with us for months or years or decades. We don’t know what these relationships will look like as they are just beginning.

However, we have been practicing at Plum health for the last 5 years and 8 months, so we have a pretty good idea of what to expect.

Ongoing members vs Members who have joined and left

There is some nuance to this conversation - and it starts with two distinct groups. You have to think about the members who are still with us and the members who have joined and left our practice as two distinct groups.

Our Plum Health DPC practice has had a total of 2,499 patients enroll in our practice and we currently have 1,150 active members.

Members who have joined and left

The average length of membership for a patient that has joined and left is 10.24 months. This feels about right for me as a physician. A lot of the folks who enroll with us are in between jobs, or in between cities, or making a career transition, or they’re not satisfied with the care that they’re getting from another health care system. They join our practice as a stop gap between insurance coverages, or they join our practice for us to help them through a rough psychological or physiological or medical transition where they may need more care than typical.

After about 10 months of care, they’ve moved on to the next thing. This is an important piece of information for our business because it helps us to inform our price point. If our average price point is $60 per member per month, then we typically make $600 per member who enrolls in our service.

ongoing members or currently active members

The average length of membership for a patient that has joined and is still active or still currently a member of our practice is 24.69 months. This is amazing - at Plum Health, we love taking care of our patients for the long term.

This information is helpful, because it can continue to inform our price point going forward. The two pieces of data above help us calculate the value of each new patient that enrolls in our practice.

Why does this information matter?

The next piece of data to look at would be how many appointments and chart interactions, or about how much time our doctors spend with each patient, to calculate the value per hour for each physician’s time and effort.

From the Patient’s perspective

Most patients who enroll in our service perform the mental math in their head. They might say to themselves, “if I enroll in this service at $60 per month, and I plan to stay with Plum Health for 1 year, I will spend about $720.”

The second part of that conversation is something like, “in order for my insurance to kick in, I need to spend $7,000 (my deductible) on my own health care before my insurance pays for any of my health care expenses, so paying about 10% of that amount or $720 to Plum Health for unlimited primary care is a good deal.”

Or, if the patient is uninsured, they may say “I have no health insurance, and paying $720 a year to Plum Health to keep me out of the hospital or the emergency department or the urgent care is well worth it for me.”

Closing thoughts

I hope that this blog post is helpful for you as you start and grow your own direct primary care practice. This is an important model for our health care system here in the United States as direct primary care doctors tend to help folks who are left out by the traditional fee-for-service system.

Understanding how long patients typically use your service is invaluable. Understanding the lifetime value of the patients who uses your practice is also invaluable. These numbers will give you an idea of what you can expect in your direct primary care practice. The caveat is that our patient population at Plum Health DPC in Detroit may be younger and more mobile than other direct primary care practices.

Thanks for reading and have a great day,

-Paul Thomas MD with Plum Health DPC

Did you enjoy this blog post? If so, read more of Dr. Paul Thomas’ thoughts on Direct Primary Care in the Startup DPC book, and watch more videos about direct primary care in the Startup DPC courses!

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Tips for Developing an Amazing Website for your Direct Primary Care Practice

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Tips for Developing an Amazing Website for your Direct Primary Care Practice

As a primary care doctor, you are unlikely to have any history of building a website or creating content online, and THAT IS OKAY. You don’t need to know how to write code, and you don’t need to know how to do complicated tasks online. However, you should know how to use a service like SquareSpace or Wix or GoDaddy to build your own website.

I like using SquareSpace, and both my PlumHealthDPC.com and this StartupDPC.com are built on the SquareSpace platform. It takes anywhere from 2 to 8 hours to build a decent website. You have to choose a theme and select the pages that you want. Some companies are going to a “one page website” where you have all of your information on one page without clicking to other pages. This would greatly simplify your web-building process.

However, as you can see, I take a more traditional or typical approach to my website. I have a main page, an about page, an FAQ page, a blog page, and then my schedule/enroll page. This meets the expectations of most of my potential customers and allows them to easily engage with my content.

I can also write many blog posts and add that information to my blog page, which increases my traffic and search engine optimization.

Search engine optimization is the process of improving the quality and quantity of website traffic to a website or a web page from search engines. SEO targets unpaid traffic rather than direct traffic or paid traffic.

I have a lot of doctors ask me to develop their website for them. I charge $3,000 for this service as it takes a good amount of time and there is a decent amount of back-and-forth to get things just right for the doctor. Most good web designers charge this amount of money, and you can find someone to do the work for you on a site like Fiverr or UpWork or a similar free-lance friendly website.

I will say, your website is the most important part of your business. It’s the front door to your business, and it acts to attract new patients and enables them to enroll seamlessly. You must have an excellent website that is easy to use and does not have any broken links.

On a final note, I’m taking a digital marketing course right now to improve my digital marketing skills, and this was one of the topics: how to improve your website!

When you are building your website, it’s important to identify the goal of your website. For my Plum Health DPC website, my goal is to get more people to enroll in our direct primary care service. We achieve this goal by writing content on our blog to improve search engine optimization, and then sharing that content on our social media channels and back-linking to our blog to attract new readers, who hopefully become new members.

When you are building your website, it’s important to identify the goal of your website. For my Plum Health DPC website, my goal is to get more people to enroll in our direct primary care service.

Additionally, your website should be easy to navigate - as the old saying goes, keep it simple silly! If you have too much information, a cramped and crowded website, it may drive people away. Having enough white space allows your website to breathe and your potential customers to feel relaxed as they read through your information.

You should have your logo on each page, as that can add more credibility and professionalism. You should choose fonts and colors that complement your brand and your logo. I like to include videos and multimedia - written content paired with images and videos can help communicate the information to different audiences who consume information in different ways.

Additionally, your website should be easy to navigate - as the old saying goes, keep it simple silly! If you have too much information, a cramped and crowded website, it may drive people away. Having enough white space allows your website to breathe and your potential customers to feel relaxed as they read through your information. You should have your logo on each page, as that can add more credibility and professionalism. You should choose fonts and colors that complement your brand and your logo. I like to include videos and multimedia - written content paired with images and videos can help communicate the information to different audiences who consume information in different ways.

Thanks so much for reading! If you love this content, then check out our Sales Funnel course, where I go in-depth on how to attract more patients to your direct primary care practice. As a big hint, you need to have content on your website and a seamless way to enroll on your website to achieve this goal.

Have a great week!

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

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Which electronic medical record system do you use for your direct primary care practice?

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Which electronic medical record system do you use for your direct primary care practice?

We use ATLAS MD EMR or electronic medical record system. There are a lot of pros to using ATLAS, for both patients and doctors. In this video I answer a question that was emailed to me this week:

We have chosen Atlas.md as our EMR due to the payment integration and ease of use. I see that you also use Quickbooks and Atlas.md.

My questions are:

  • Do you do any sort of integration to get your financial data (income) out of Atlas and into QB? Do you use the Desktop or Online version of QB?

  • Do you use the Atlas Phone/SMS integration for interacting with patients?

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How do you price your Direct Primary Care Practice to earn $70 per member per month?

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How do you price your Direct Primary Care Practice to earn $70 per member per month?

Today I got an email asking a great question:

Dr. Thomas,

I'm getting close to giving my 120-day notice to my employer, with a target DPC start date of September!

I have a pricing question. If you prefer not to answer, I totally understand. In your business plan, you stated that your target average PMPM monthly rate was $70. Have you been able to achieve that?

Thanks, and have a great day!

This is a great question because in your business plan, you should figure out how much money you need to make to have a successful and thriving practice.

Because we work in a lower income community, Southwest Detroit, our pricing is lower to meet the needs of our community. Our per member per month revenue is around $50. We recently increased our prices to bring our per member per month revenue up to $55 monthly. This will help us to be more sustainable and profitable in the long term.

If you were to price a Direct Primary Care practice to make $70 per member per month, it would probably look like this:

  • $25/month for children

  • $65/month for young adults

  • $80/month for older adults

The cut off for kids would be 17 and under, the cut off for young adults and older adults would be around 40 or 45 or 50 years of age, depending on your demographic.

@plumhealthdpc I help doctors start and grow direct primary care practices via #StartupDPC - today I’m answering a question on pricing 💯 #doctor #familymedicine ♬ 茉 莉 花 茶 - CHILLVIBE

I’ve been active on TikTok and I’m happy to answer any questions you have like this!

Best of luck in building your DPC practice,

-Dr. Paul Thomas with Startup DPC

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Latest Review for Startup DPC Book

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I love reading the reviews for the Startup DPC book - I really appreciate all of the kind words you’ve said about the material therein! Here’s the latest:

Dr. Paul presents the full story here on how he himself started his DPC clinic. While some books might be vague about the general processes, Dr. Paul tells you exactly what he did, what he used, and how much everything cost. It's important for people to know what they're really investing when it comes to DPC clinics, and Dr. Paul makes shares everything in his book. He does a great job articulating each step, and he writes in a way that is easy to read. He has a great story and a great approach that would benefit anybody who might be interested in DPC. Definitely worth the read.

I love being a part of this direct primary care movement. Reflecting on 2021 , the Direct Primary Care movement is continuing to grow every day and every week - there seems to be a new direct primary care doctor starting their own practice just about every week, and it’s amazing to see this happen. Here’s to the continued growth and success of the movement and here’s to a healthier nation and a stronger doctor-patient relationship.

Thanks for reading and have a great week.

-Dr. Paul Thomas with Startup DPC

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Sample Voicemail for a Direct Primary Care Office

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Sample Voicemail for a Direct Primary Care Office

Throughout starting and growing a direct primary care practice, you will need to continuously refine your operations. One of the most important parts of growing a practice is having an excellent experience for your patients and potential patients when they call your office line. If you can answer your phone within a few rings and address any concerns quickly and with kindness, you can reap continuous business and referrals from satisfied patients. Answering the phone in a timely manner is crucial. But, in the event that you cannot answer the call due to a capacity issue or a cell signal issue, having a phone tree or voicemail is very important.

One thing I’ve learned over the years is that pharmacies expect the voicemail to say not only the practice name, but also list the doctors within that practice.

Here’s an example of our daytime voicemail:

"You've reached Plum Health DPC, the offices of Drs. Thomas, Orlich, and Rabaut. Please leave a voicemail and we will return your call as soon as possible. Alternatively, email [our email address]. Our office hours are 9 am to 5 pm, Monday through Friday. If you've reached our voicemail during this time, you can try calling back in 1 hour. Our fax number is [our fax number]. If this is an emergency and you cannot wait, please dial 911 or go to your nearest emergency department."

Here’s an example of our after-hours voicemail:

"Thank you for your call. You have reached the after hours line for Plum Health DPC, the offices of Drs. Thomas, Orlich, and Rabaut. Please leave a voicemail and we will return your call as soon as possible. Alternatively, email [our email address]. Our office hours are 9 am to 5 pm, Monday through Friday. If your concern is non-urgent, please call back during our office hours. Our fax number is [our fax number]. If this is an emergency and you cannot wait, please call 911 or go to your nearest emergency department."

Obviously, our goal is to have every phone call answered promptly with a calm and kind demeanor. Sometimes, due to cell service issues or capacity issues, these call can be missed. Setting up a voicemail for these contingencies is important.

-Dr. Paul Thomas with Startup DPC

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Reviews for Dr. Paul Thomas at the DPC Summit 2021

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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