How to Start A Direct Primary Care Practice

How to Consult with Specialists as a Direct Primary Care Doctor

How to Consult with Specialists as a Direct Primary Care Doctor

This is a big one for folks taking the plunge into Direct Primary Care - how do you as a Direct Primary Care doctor consult with specialists? Because you’re not “in-network”, how do you get patients the care they need outside of your office?

There are a number of ways to go about this and I’ll tackle three of them in this blog below. This blog post was prompted by a community question:

Message: Dr. Thomas,
I am about to start a DPC clinic. I completed family medicine in 2005 and am tired of the headache and hurdles of traditional primary care. One of the biggest things holding me back is how to refer to specialist? In one of your videos--you mentioned using a specialist service(for difficult ekg reading, endocrinology..etc). What was the name of that service?
Also--how do you deal with preventive stuff---like colonoscopy? stress test--if needed?

Any help in this category is greatly appreciated.

I am glad you got away from the insurance companies. I own a medical and day spa and will incorporate the monthly fee to cover facial/massage on the months the members do not need medical care.

Thanks again,

Option #1: Use the time that you have

Because you’re a Direct Primary Care doctor, you now have more time to read up on diagnoses and more time to guide your patients through the care that they need. By leveraging the increased time that you have, you can take care of more problems in your office and therefore have to refer less often.

Option #2: Develop close relationships with specialists in your community

If you are able to develop close relationships with specialists in your community, especially the private and non-hospital-affiliated specialists in your town, you can discuss cash prices for your patients.

I try to keep in close contact with my physician colleagues, and that’s part of the reason why I attend Wayne State University School of Medicine alumni networking events. Many of the opportunities that you find to lower the cost of care for your patients will come from your network.

I try to keep in close contact with my physician colleagues, and that’s part of the reason why I attend Wayne State University School of Medicine alumni networking events. Many of the opportunities that you find to lower the cost of care for your patients will come from your network.

For example, by working with a local gastroenterologist in our region that owns a free-standing endoscopy suite, we were able to get cash prices for Esophagogastroduodenoscopies and Colonoscopies. They are roughly $1,000 each, which pays $400 for the facility, $300 for the Gastroenterologist to perform the procedure, and $300 for the Anesthesiologist.

Another example is Cardiology. We worked with a local cardiologist to get pricing on common tests that we need for our patients. Specifically, the Echocardiogram is $199, an Exercise Stress Test is $99, and a Holter Monitor is $99. These are very reasonable prices and they help us make better decisions for our patients.

Additionally, you can request visit prices/appointment prices from the specialists in your community.

Option #3: Leverage an online or e-Consult platform

As a Direct Primary Care doctor, you have the option to consult with specialists via online or e-Consult platforms. The platform that I, and many DPC doctors, use is Rubicon. Rubicon allows you to write up a consult and include PDF files or image files - EKGs, skin lesion photos, pathology reports, lab tests - and send this information to the consultant/medical specialist of your choice. The Rubicon platform has over 100 specialists and sub-specialists from Cardiology (Electrophysiology, Pediatric, Heart Failure, Lipid Disorder) to Endocrinology, Plastic Surgery, Transgender Health, and Women’s Health. The spectrum of consultants is quite broad here and the responses are very often thoughtful and helpful.

This is a great service and I enjoy using it, but be aware that you are liable for any decisions that you make for your patients based on using this service. Finally, if malpractice litigation was brought against you or Rubicon for an outcome related to using this service, you would be responsible for not only your only legal costs, but the legal costs related to Rubicon’s involvement. Caveat Emptor, read the Indemnification clause from Rubicon’s Contract:

14.      INDEMNIFICATION; LIMITATION OF LIABILITY:

14.1.    General Indemnity: RMD and CUSTOMER will each indemnify, defend and hold harmless the other and its officers, directors, employees, agents and Specialists from and against any and all direct third party claims, costs or expenses (including reasonable out-of-pocket attorneys’ fees), and payment of damages awarded by a court of competent jurisdiction in a non-appealable final judgment or agreed to in settlement (“Claims”), resulting from the gross negligence or willful misconduct of the indemnifying party; provided, that the indemnified party promptly notifies the indemnifying party of the Claim, gives the indemnifying party sole control over the defense and settlement of the Claim, and reasonably assists the indemnifying party in the defense of the Claim at the indemnifying party’s expense, provided such settlement provides for a full release of all Claims against the indemnifying party and its affiliates. For clarity, CUSTOMER’s indemnification obligation will include indemnification for the gross negligence or willful misconduct of all of the Users and Drafters.

Yeesh.

Thanks for reading, thank you for the question, and let me know what topic you’d like me to tackle next!

-Dr. Paul Thomas with StartUpDPC

How Personal Branding can help you grow your Direct Primary Care Practice

Intro

Tonight, I went live with the Direct Primary Care Alliance and talked about how personal branding can grow your Direct Primary Care practice. This is a huge topic, and I tried to tackle as much as possible in under an hour!

Currently, I’m working on my second course on this subject, Personal Branding for Direct Primary Care Doctors. If you haven’t seen our first course on Building a Sales Funnel, check it out here.

Why it’s important to Build a Personal Brand as a Direct Primary Care Physician.

2019 Dr. Paul Thomas on Building a Personal Brand to grow your Direct Primary Care Practice.png

Why is it important to build a personal brand as a Direct Primary Care Physician? Simply, building a personal brand is a great way to attract new patients to your practice. People/your potential customers spend a lot of time on Facebook. Instagram, and LinkedIn and these can be places where you can show your authentic self, where you can demonstrate your caring and compassion, where you can develop genuine relationships with people through social media.

Building a personal brand is all about communicating your character to your community or to your target audience. You can share about your successes and failures, your hopes and dreams, what you believe in, and why you decided to start a Direct Primary Care practice.

When you do these things, when you share about yourself in an honest and transparent way, your story and your character will start to resonate with people in your audience. They will identify with you and start to trust you for the person that you are, the caring, compassionate, and authentic physician in their community.

When you are a primary care doctor, you’re asking people to trust you with their most important resources: their health. By communicating your character, your ethos, and your values through these social media platforms, you can start to build that foundation of trust.

Question from the Community: How did you work with Veterans?

My name is Dr. Paul Thomas with StartUpDPC and I'm here to help you start and grow your Direct Primary Care practice. Our question this week comes from a Direct Primary Care doctor in the community. They want to know more about the health care services that we provide for Veterans in our community through our practice, Plum Health DPC.

“Hello again. This is _______ from _____ DPC in _______, __. I just saw that you have partnered with the VA to provide care for veterans. I currently have 4 patients who are vets that come to me and I would love to be able to help more of them as we all know this is a significantly under-served population. If you have a minute I am very interested in a few things regarding this partnership:

1. How you went about getting this partnership

2. How you are reimbursed (vets or VA paying?)

3. Did you have vets that were currently on your panel that were pulled into this (as I assume there is some sort of gov reimbursement)?

4. Anything else worth knowing if able to get into this?

If you have some time I'd love to see your thoughts as I think this would not only help my practice grow, but provide a much needed alternative for vets besides going into a broken Fee For Service community system.

Thanks so much, _____.”

I love this question! You want to help veterans with their primary care services, and I absolutely love that. That’s what I’m out here doing as well. To be clear, I’m not partnering with the VA or the Veterans Administration.

What I did, was I partnered with a small business called Veterans Care Network. I developed a relationship with Shane and Jenny who run the Veterans Care Network. We built a relationship over time and they grew to trust me and want to business with our practice, Plum Health. They developed an application process, and selected two veterans to send to our practice.

You can read more about it on my practice’s blog, Plum Health. I go into more detail with our (first ever!) YouTube video.

StartUpDPC tackles how to work with Veterans in our latest blog post! It starts with developing relationships.

StartUpDPC tackles how to work with Veterans in our latest blog post! It starts with developing relationships.

How to Boost A Facebook Post for your Direct Primary Care practice

Once you create engaging content on your blog, you can share that engaging content on your social media channels. LinkedIn and Facebook are perfect for sharing links from your blog posts to your contacts on your social media channels. Why is this? Because Facebook and LinkedIn allow their users or your audience to click through these links to reach your content.

The whole point of having a Sales Funnel is to move people from where they hang out - Google, Facebook. LinkedIn, Instagram, YouTube, and Amazon - to your website. You see, your potential customers cannot purchase your service via Google, Facebook, LinkedIn, Instagram, YouTube, or Amazon. Your potential customers can only purchase a membership from you when they’re on your website.

This is the bottom line: you want to drive traffic from these big websites and social media platforms to your website. So, once you create an engaging piece of content on your blog with an eye-catching image, you can then share that piece of content to your social media channels.

Facebook will actually tell you when your post is outperforming your other posts. For example, you might see a notification from Facebook that says “This post is performing better than 85% of your content” or something like that. When this happens, this is a reasonable time to boost your post.

Additionally, Facebook will sometimes offer you $10 to boost a post. This recently happened, so I took advantage of the $10 deal. Here’s what that looked like:

This is the view of my personal Facebook feed, tied to my business account with my Direct Primary Care Practice, Plum Health DPC. Once I log into my personal Facebook page, Facebook prompts me with a $10 Ad Credit to use towards my business account.

This is the view of my personal Facebook feed, tied to my business account with my Direct Primary Care Practice, Plum Health DPC. Once I log into my personal Facebook page, Facebook prompts me with a $10 Ad Credit to use towards my business account.

Above is the view of my personal Facebook feed, tied to my business account with my Direct Primary Care Practice, Plum Health DPC. Once I log into my personal Facebook page, Facebook prompts me with a $10 Ad Credit to use towards my business account.

Here is the close-up view of that $10 Ad Credit - pretty enticing deal from Facebook.

Here is the close-up view of that $10 Ad Credit - pretty enticing deal from Facebook.

Once you finish boosting your post, you will see that your $10 Ad Credit has been claimed.

Start Up DPC Direct Primary Care Boosting a Post on Facebook Part 3.png

Once you log in to your Facebook for Business Account, you can see the results of the Ad and Ad Credit. It’s too soon to see any results for this one, but for past $25 investments, I’ve reached about 3,000 new people and had 137 and 381 people engage with my content. See below:

Once you log in to your Facebook for Business Account, you can see the results of the Ad and Ad Credit. It’s too soon to see any results for this one, but for past $25 investments, I’ve reached about 3,000 new people and had 137 and 381 people engage with my content.

Once you log in to your Facebook for Business Account, you can see the results of the Ad and Ad Credit. It’s too soon to see any results for this one, but for past $25 investments, I’ve reached about 3,000 new people and had 137 and 381 people engage with my content.

Thanks for reading this basic overview on how to boost a Facebook post for your Direct Primary Care practice. If you’d like to take a deeper dive and see more about this process, check out our course on building a Sales Funnel for your Direct Primary Care practice.

-Dr. Paul Thomas with StartUpDPC

Why StartupDPC?

StartupDPC exists because we believe in the Direct Primary Care movement and we want to help doctors start and grow their DPC practices.

My name is Dr. Paul Thomas and I’ve been planning, building, and growing my Direct Primary Care practice over the last 3 years and I want to share everything that I’ve learned during that time with you. I went from 0 patients in November 2016 to over 500 patients today and I recently hired a second physician to help me manage the demand.

In addition, I’ve become a thought leader in the Direct Primary Care field, as I have advocated for the advancement of DPC in Washington and I’ve spoken at the national Direct Primary Care conferences on a range of topics.

I want to accelerate your growth, decrease the number of mistakes that you make, and help you achieve a fulfilling practice in Direct Primary Care. I want to do this because I believe in Family Medicine and Family Physicians, and their ability to deliver excellent primary care services to their patients and to their communities.

I’ve consulted with several Direct Primary Care doctors who have gone on to create successful, thriving Direct Primary Care practices. I want to share the knowledge that I’ve gained and share the essence of these consulting sessions with you so that you can grow your practice more quickly.

More to the point, there isn’t a great coaching resource in the marketplace right now, and we want to provide an excellent service to accelerate the growth of the DPC movement.

We aim to answer the most commonly asked questions in the Startup Phase and then we have additional resources for you to use during the growth phase. We will also add modules as needed, specifically around hiring another physician and similar topics.

To get started, head over to our courses page.

Thanks for reading and good luck with starting your DPC practice - let me know if I can be helpful along the way!

-Paul Thomas, MD

Dr. Paul Thomas speaking to an audience of over 300 at the AAFP Direct Primary Care Summit aka DPC Summit in Chicago in June 2019

Dr. Paul Thomas speaking to an audience of over 300 at the AAFP Direct Primary Care Summit aka DPC Summit in Chicago in June 2019