How to Start A Direct Primary Care Practice

Here I am speaking at the American Academy of Family Physicians DPC Summit in 2018

Here I am speaking at the American Academy of Family Physicians DPC Summit in 2018

How to start a direct primary care practice


Starting a Direct Primary Care practice can be challenging - my goal is to make this process as easy as possible for you. In this guide, I will walk you through the basic steps of starting your Direct Primary Care practice. This narrative will be supported with posts from our Blog and video content.

Why am I qualified to help you start a Direct Primary Care Practice?

Who am I to help you in this process? My name is Paul Thomas, MD and I’ve successfully built a Direct Primary Care practice from the ground up. I’ve gone from 0 patients in 2017 to over 500 patients today, and I’ve added a second Family Medicine Doctor to my practice to help me keep up with the demand. Moreover, we’ve done this in Southwest Detroit, an economically disadvantaged area and a Health Professional Shortage Area. I’m proud to work here and proud to serve here, and let this be proof that DPC practices can be successful anywhere in America.

Not only have I successfully launched my own practice, but I’ve consulted with several Direct Primary Care physicians who have created their own successful practices. I have first hand experience in creating templates and materials to support the growth of the Direct Primary Care movement.

Furthermore, I’ve been an invited and featured speaker at National Conferences on Direct Primary Care. I’ve spoken at the DPC Nuts and Bolts Conference in Orlando, Florida. I’ve also presented at the American Academy of Family Physicians’ (AAFP) DPC Summit on a variety of topics, from how to start a Direct Primary Care practice to branding and marketing your Direct Primary Care practice.

Do you have the right mindset to start a direct primary care practice?

Starting a Direct Primary Care practice takes guts. And, it’s a difficult process to start a DPC Practice - kind of like climbing a mountain. It takes guts to get out of an employed, salaried position with nice benefits and launch yourself headfirst into a world of entrepreneurship and risk.

So the first thing I want to tackle here is your mindset. Are you willing to give up the guaranteed income to take care of your patients on your own terms? Are you willing to forego the benefits of employed practice to become the doctor you were meant to be? Are you willing to take a risk to create the practice of your dreams?

If you answered yes to these questions, without hesitation, then you’re ready to take the next step!

Be Inspired. Dream big.

Next up, you need to be inspired - you need to dream big! What do you want your practice to look and feel like? What paint colors will you use? What kind of furniture will you have and what kind of artwork will hang on your walls? Visualize your ideal practice space and be inspired by what you can create. I would be lying if I told you that this process is easy, so create a bold vision for yourself and for your future that will excite you and motivate you to see this journey through to the end.

Come up with a great name for your practice

Now we’ve come to my wheelhouse - branding and marketing. A name says so much about who you are and what you do, so this is a crucial step in your journey to success. A misstep here can create a ton of pain down the line, so it’s worth taking the time and making an investment into getting this perfect.

Names can vary across the board, but the best advice is to keep it simple. Your name should be easy to spell and easy to pronounce. Avoid the SAT words like Salubrious and focus more on either your last name if you want to be a solo doctor, the name of your town or neighborhood if you want to be a single-practice DPC, or a slick or catchy name if you have grander aspirations, like becoming a regional or National DPC powerhouse.

Write a business plan for your direct primary care practice

Writing a business plan is a crucial step in starting and growing your Direct Primary Care practice. This is a living, dynamic document that changes as your business changes and that serves as a template for your growth and prosperity over the long term. There are a few essential sections, like an executive summary, a starting budget, a monthly budget and projected expenses. You should also have descriptions for the employees in your practice and what their daily, weekly, and monthly tasks look like.

In order to start a successful Direct Primary Care practice, you need to have an excellent business plan. I get asked about our business plan for Plum Health DPC in Detroit often, and often enough that I created a course to teach other doctors how to write their own excellent business plan.

In addition, if you don’t have a break even analysis and if you don’t focus on the kind of money you want to end up with after you account for your overhead and taxes, then you may end up with a less-than-fulfilling practice. Ben Franklin is attributed with the saying, “If you fail to plan, you are planning to fail” and it’s worth taking the time to plan out your moves in your DPC practice ahead of time. The business plan allows you to do this.

If you’d like to take our course on writing a business plan, check out our link, here. It will walk you through all of the essential elements of the business plan, it will show you the break even analysis, and you will be able to download our business plan for Plum Health DPC. By taking this course, you will accelerate your growth along your journey to starting a Direct Primary Care practice.

Create an excellent website

I’ve said it before, and I’ll say it again: if your website sucks, you suck. Think of your website as the front door to your business. It has to function, it has to work seamlessly, and it has to communicate your value to the world. If your website is unable to do this, or if it takes too long to load, or if your sitemap or layout is clunky, it can cost you patients and prolong your time from getting started to becoming full, sustainable, and profitable.

With the strength of search engines like Google, people will eventually find your website. And, once they arrive to your website, you want to answer their questions, overcome their hesitations, and get them to convert from ‘just thinking about this membership model for healthcare thing’ to becoming enrolled members in your practice. Making sure your website is streamlined, functional, and optimized for search engine traffic is crucial in having a successful and sustainable DPC practice.

build out your social media channels

Next up, you need to create your social media channels. You and your business/brand should have a strong presence on social media channels like Facebook, LinkedIn, and Instagram.

By having a strong presence on these channels, you can funnel traffic from these channels to your website. This is what is called a sales funnel.

The Direct Primary Care sales funnel. You need to develop a Sales Funnel to have a successful and sustainable Direct Primary Care practice.

The Direct Primary Care sales funnel. You need to develop a Sales Funnel to have a successful and sustainable Direct Primary Care practice.

You see, people don’t hang out on your website. Rather, they hang out on Google, Facebook, Instagram, LinkedIn, YouTube, Amazon, etc… If you want to get people to purchase a membership in your practice, you have to figure out how to get them from these websites and social media channels to your website. Because THEY CAN’T BUY YOUR PRODUCT ON SOCIAL MEDIA CHANNELS, they can only buy your product on your website.

This concept is hard for Direct Primary Care doctors to understand, so I’ve created an entire course dedicated to teaching DPC doctors how to take full advantage of the sales funnel. The sales funnel is one of the most crucial aspects to creating and sustaining a Direct Primary Care practice.

How to Find A PHysical Space for your direct Primary Care practice

After you’ve developed your brand and digital spaces for your Direct Primary Care practice, you’ll need to develop a physical space for your Direct Primary Care practice. There are several ways to make this happen, and the easiest among them is to make house calls. When I started Plum Health DPC, I did not have a physical space, so I started by making house calls. I had about 10 people sign up for my services in the first month of operation, and then I decided to sub-lease a physical office.

After making house calls for 2 months, I started seeing patients in a one-room office of 190 square feet that I subleased from a school. Even though it was small, it was functional. It had plenty of room to fit my desk, medications, supplies, equipment, EKG machine, exam table, comfy chair, scale, and diagnostic equipment. From here, I booked myself solid with people I knew or prospective patients and quickly built a sustainable practice.

Once I reached 350 patients, I started seriously considering a lease. I found a new building and signed a lease with them for 1,700 square feet, or ten times larger than my humble beginnings. Now, we have over 530 patients and we’re going to be moving to that larger space in less than 1 month! There are so many pitfalls and opportunities when looking at properties, signing a lease, negotiating for tenant improvement funds, etc…

If you live in a city or a town with some nice, Class A medical space, perhaps you won’t need to build out an entirely new office. It is much more expensive to build out an office as it requires a hefty up-front investment, but it was necessary in my marketplace.

If you are unable to find a lease in your community, one opportunity would be to get a PO Box from your local US Post Office branch and have that be your address for the time being - you can then register your business to that address and form your entity, like an LLC, S-corp, or C-corp.

Deliver an excellent service

You can deliver an excellent service by taking the time to listen fully to your patients.

You can deliver an excellent service by taking the time to listen fully to your patients.

Can you reliably create a “wow” experience for each and every one of your patients/customers? In a world where there are literally hundreds of options for receiving health care services - urgent cares, minute clinics, fee-for-service offices, emergency departments, concierge doctors, telehealth apps, online direct-to-consumer companies, chiropractors, naturalists, doulas, and shamans - how will you make your Direct Primary Care service stand out from the field?

How can you deliver that “wow” experience? By responding immediately to texts, phone calls, and emails. By meeting your patients at the door, shaking their hand, and walking them back to your private exam room. By reading up on their conditions before they walk in for follow up, and knowing all about their history, their last blood pressure readings, and last set of labs. You can differentiate yourself by being excellent.