Latest / DPC Life: Direct Primary Care Podcast / 10 Fears That Keep Physicians Stuck (And How To Finally Start Your DPC Practice)

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10 Fears That Keep Physicians Stuck (And How To Finally Start Your DPC Practice) · DPC Life: Direct Primary Care Podcast

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  When they say that they're thinking about starting a direct
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  care practice, there are few questions that keep coming up
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  again and again. They seem to be universal.
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  So I'm going to talk today about 10 of the most common fears that
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  I hear from physicians when they start thinking about opening a
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  direct private care practice. Welcome to DPC Life, the podcast
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  where independent doctors share real stories, bold ideas and the
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  freedom of doing medicine on. Your own terms.
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  I'm your host, Doctor Anne Gonzalez, and together we'll
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  explore the winds, the struggles and everything in between.
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  Let's dive in. Usually it's me and someone else
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  talking and this time it's just me.
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  So the last time I did a bonus episode, I was talking about our
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  DPC Women Connect event and one thing that I've been working on
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  since then is the independent practice path.
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  I started this program because because when I talk with people
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  who are thinking about starting a direct care practice, a lot of
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  times they think about it and then they continue thinking
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  about it. They don't really get any
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  forward progress and sometimes it stays for a while, like once
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  or even years. It took me personally about 8
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  years from the time I heard about DVC to actually when we
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  opened. Now, when I first heard about
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  DPC, it was very new. We had hardly any resources at
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  the time, I think, to help people with getting them
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  started. And at the time when I heard
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  about DPC, I just kind of thought, oh, that's wonderful, I
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  would love to do that, but it's not for me because I didn't
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  think I could do it #1 and and so I just kind of went in the
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  back of my head. So what I'm trying to do is help
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  people not take years before they open their DPC practice
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  because right now we know that the healthcare system is really
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  in a difficult situation. It's quite difficult,
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  particularly for primary care. Obviously the doctors are having
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  to see too many people in too little time.
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  That's not what they thought they would be doing when they
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  went into medical school. So I want to help people get out
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  of fee for service medicine so that they can open their own
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  direct primary care practice and practice medicine the way they
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  thought they would when they went into medical school.
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  The kind of practice when, you know, they wrote their personal
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  statement about why they wanted to do medicine and how they
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  wanted to. What I've heard from people when
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  they say they're thinking about starting a direct care practice,
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  there are a few questions that keep coming up again and again.
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  They seem to be universal. So I'm going to talk today about
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  10 of the most common fears that I hear from physicians when they
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  start thinking about opening a direct private care practice.
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  And I'm just going to read some of these off because I can't
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  remember all of them. I can't remember all of them off
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  the top of my head. So forgive me for reading some
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  off my paper here. So number one, will patients
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  actually follow me? And this is this is something
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  that pretty much everyone thinks are they going to follow me
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  after I leave my employed practice?
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  And generally, what seems to be pretty consistent is if you're
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  coming from an employed practice and opening ADPC practice,
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  anywhere from about 5 to 10% of your previous patients follow
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  you. You're a good doctor, you're a
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  good physician, and people will follow you when they see the
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  value and they are attached to you.
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  So you know you're not going to get 100%, obviously, but you're
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  not going to get no one. I know that's a double negative,
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  which means it's positive. You're going to get some people,
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  you know, some people are a little less and some people are
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  more. But that's what it kind of
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  generally seems to come out to. About 5 to 10% of your previous
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  patients will follow you into your new direct private care
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  practice #2 How do I explain the membership fee?
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  So this is kind of a hard point for physicians just because
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  we've never had to explain the fees for our services before
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  because it's always been billed through the office and someone
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  else is taking care of that and we don't have to deal with the
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  money because it makes us uncomfortable saying this is how
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  much this costs. I mean, I didn't know how much
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  like a vitamin D lab was. And when people would come in
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  and say it was $200, for example, I was shocked.
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  I had no idea that that's how much it was.
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  So that's, that's only one thing that you have to explain.
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  Now, how do you explain the membership fee?
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  Well, that's completely different because how do you
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  explain it to people who already have insurance and explain that
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  they're going to have to pay more?
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  That's something that you learn and you get used to it, but
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  definitely it's something that you'll have to practice.
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  The third question is when should I start telling people
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  that I'm leaving? This is all.
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  It's very dependent on your situation, on your contract.
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  Do you have a non solicit clause?
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  And and so it depends on your contract.
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  If you don't have a non solicit clause, if you can, I would
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  start telling them as soon as possible so that they can Start
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  learning about DPC and getting the idea into their heads so
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  that if they do decide they want to follow you, they understand
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  what they're getting into. So it really it depends.
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  So if you have a non compete slash, non solicit, that makes
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  it a little harder, but there are ways to kind of not
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  necessarily get around it, but sort of get around it.
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  The next common question is what if I leave my job too early and
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  I don't have the patience yet to support me or my family
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  financially? Obviously you'll have to look at
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  your finances prior to opening your practice and take a good
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  hard look and be very realistic about how much you know, how
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  long kind of how much runway do you have before you need to earn
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  a certain amount. And some people have side gigs
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  while they're opening their practice, which can be good or
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  bad. Obviously it's good to keep you
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  flush, but also it will take away time from your from growing
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  your new practice. So pros and cons to that.
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  You have to figure out how much you're going to need to make and
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  and I work backwards to try and figure out how much are you
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  going to charge people for their monthly membership.
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  Another question is what if I wait too long before talking?
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  You know, talking to people about DPCI do think you you
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  can't start too early if you're allowed to talk to your patients
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  about it if you don't have a non solicit clause.
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  Also, if you even if you do have a non solicit clause, you know,
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  you can start talking about direct primary care.
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  It doesn't necessarily mean that you're going to go into direct
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  primary care, but if you want to, and if there isn't anything
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  against in your contract saying that you can't post on social
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  media about certain topics, then there's no reason you can't
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  start talking about direct primary care.
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  I would see that as kind of a signal to people that you might
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  be opening a direct primary care practice.
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  Another question, what do I actually do first when I'm
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  opening a practice? So there's a lot of checklists
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  and information online about what do you do?
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  Like do you get your PLLC first you need to get a bank account,
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  your register with your state, the medical board in your state.
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  So So what do you do first? Another thing that stumps people
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  is how do I talk about direct primary care without sounding
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  awkward or unsure of things? Again, this is another kind of
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  go along with one of the earlier fears about how do I talk to
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  people about it? How do I explain the membership
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  fee? A lot of physicians say that
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  they feel the meet and greets are uncomfortable and it may be
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  just because they're still uncomfortable with explaining
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  direct primary care. And the only way to get over
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  that or to get past that is to just practice it and work
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  through your elevator pitch and repeat it over and over and over
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  to the point where it just kind of rolls off your tongue and
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  like it's nothing for you to say it.
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  So you just have to get to that point where you're just
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  comfortable with saying it. You figured out exactly kind of
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  your your normal spiel, what you want to say and just get used to
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  it and say it enough times that it just comes out of your mouth
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  without you having to think too much about it.
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  That way by that point it's going to sound natural and not
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  forced or awkward. Another question or another fear
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  that doctors have before opening their direct primary care
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  practice is how do I start building interest before I open?
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  This one is extremely important obviously because everyone wants
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  to have people either interested or on a wait list of some sort
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  before they open and you also want to have people enrolled or
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  pre enrolled already if possible before you open your doors.
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  That would give you a whole lot of cushion to have some people
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  that would feel much safer, more stable, obviously, if you had
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  patients enrolled before you even open your doors.
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  Some people think that you start marketing after you open, but
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  really the key is marketing months ahead of when you open.
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  So starting to talk to your friends, your family, people
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  like employers in your town, the Chamber of Commerce, other
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  groups like B and I. That's when you want to start
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  talking to them even before you open, because you want to
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  educate as many people as possible about direct primary
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  care so that when you're ready to open, they are educated and
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  ready to sign up. Another fear that physicians
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  have is how do I know if I'm ready to leave employed
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  medicine? That's a really hard one.
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  Again, a very individualized decision.
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  You have to look at a lot of things.
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  Obviously, it has to work out for you and your partner and
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  your family if you're caring for other family members them too.
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  So is it going to work out for your family?
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  What kind of stressors does that put on your family, on your
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  relationship? If you are going to be building
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  this practice, what stressors does it put on your finances?
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  Again, you have to look at your finances and be very honest.
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  If you don't want to go into this without having a clearview
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  of potentially what will happen to your income and how much do
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  you need to make, it's a little bit different.
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  If you loan your business because of the way taxes work,
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  you don't have to earn exactly the number that you used to make
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  in your employed practice as your salary.
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  So the numbers are a little bit different.
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  So, but still you'll want to talk to someone, an accountant
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  before you open. But beyond your family
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  situation, your finances, you'll know if you're ready, depending
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  also on your whole, your mindset, how you're feeling at
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  work. Are you feeling burned out?
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  Do you feel like it's sustainable?
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  How would you feel if you stayed in your current situation for
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  six more months, another one to two years?
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  What do you think you'd feel like in two years if you stayed
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  where you are? Would you feel the same, just
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  even more burned out? Would you feel happy about it?
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  You know, so these are things that you have to think about
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  when you're trying to figure out when you're ready to leave
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  employed medicine. And lastly, a lot of physicians,
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  when they're thinking about opening a direct primary care
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  practice will wonder if they're the only person who's thinking
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  about it. A lot of times they feel alone.
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  They feel like it's really risky and unusual for people to do
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  this. Now granted, there are not that
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  many direct primary care practices in the country, but
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  every month there are more and more people opening direct
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  primary care practices. So you are not alone.
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  You are not the only one. There is a whole community of
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  people who've already opened their direct primary care
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  practices and are in the process of opening their practices.
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  So this is not unusual. And as you can see by the number
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  of practices that have opened and survived and thrived, that
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  this isn't necessarily risky. What's risky is opening without
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  a plan, but it is possible to open a practice and do very well
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  to open a practice and be successful and thrive.
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  So it's not unusual for that to happen.
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  So you may notice that none of these questions are about how
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  you care for patients within a direct prorate care practice.
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  They are more about communication, about timing and
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  about confidence in opening. When a physician doesn't have a
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  clear path forward, then the default is to just stay in that
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  considering and thinking stage, researching stage.
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  For a long time, what I've seen is physicians that move forward
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  and open practices. They've done a few things that
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  have helped them move forward with momentum.
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  They don't just launch and then start looking for patients.
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  Instead, their momentum begins building earlier, sometimes
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  months earlier. The moment that a physician
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  starts talking about their future practice, some important
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  things can start happening right then.
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  That leads us to the framework that I've come up with called
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  the practice momentum flywheel. So a flywheel is really a cycle
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  that just it builds momentum over time and in an independent
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  practice, the cycle looks something like this.
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  We need to reach people, then your message needs to resonate
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  with them. Next you respond to their
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  questions and over time people join your practice.
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  They stay and then refer others. When they refer others that is
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  also part of your reach. And so it is a cycle.
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  Reach, resonate, respond, and retain, and gradually you gain
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  momentum. Many doctors already know that
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  they want something different. They realize that what they're
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  doing is not sustainable. What they don't need is more
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  information. What they need is a clear path
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  forward. And that's why I created the
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  Independent Practice Path. It's a small physician cohort
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  designed to help doctors move from thinking about direct care
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  to actually preparing to open over 8 weeks.
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  We focus on the decisions that actually move things forward,
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  clarifying your practice model, learning how to talk about
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  direct primary care, beginning to build interest, and putting
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  the basic systems in place that support your practice.
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  If you've been thinking about starting an independent practice
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  but feel unsure about the next step, you are not alone.
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  Many physicians are asking the same exact questions.
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  If you'd like to explore whether this path might be right for
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  you, you can start with the DPC Readiness Reflection on the
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  Harmony OPS website. It's a short exercise designed
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  to help you think through where you are in the process.
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  You can also find the link in the caption, and if you have
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  questions, just e-mail me. You can find my e-mail on the
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  Readiness Reflection page as well.
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  The next cohort of the Independent Practice path is
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  starting on March 24th and you'll be able to register until
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  March 21st. There's only a limited time to
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  sign up because people stay in the thinking about DPC stage for
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  so long and by having a hard start date that is going to
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  shift you into an action mode. I don't want people to be
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  thinking about this too long and then forgetting about it or
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  pushing it off. So if you're interested in
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  joining us, the cohort will start in a couple of weeks and I
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  can't wait to meet you and help you get started on your DPC
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  journey. Thank you for listening to the
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  DPC Life Podcast. And as always, remember that no
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  matter where you are in your DPC journey, your DPC family's got
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  your back. See you next week on the next
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  episode. Thank you for listening to DPC
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  Life. If today's conversation inspired
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  you, hit follow. Leave a review and share it with
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  a friend who's ready for change. Remember, wherever you are in
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  the journey, your DPC family has your back.
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  Until next time, keep building a practice and a life that truly
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  fits you.