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Is Your DPC Practice Failing? Why Your Accountant Might Be Wrong · DPC Life: Direct Primary Care Podcast

• 0:00
  I met more DTC doctors. I started to hear the pain that
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  they were having with finances because a lot of them were like,
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  I got into this to just have some better work life balance
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  and do the thing that I love and get into this to run a business.
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  But now I'm having to run this business and it feels like I'm
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  pulling teeth trying to do my QuickBooks every weekend.
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  I'm ADPC patient and we're actually forcing all of our
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  staff to get on a DPC membership and we worked through his
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  numbers and you know, at the end of that meeting we were able to
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  determine he made $80,000 his first year in running his DPC
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  practice. Welcome to DPC Life, the
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  podcast. Where independent?
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  Doctors share real stories, bold ideas, and the freedom of doing
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  medicine on your own terms. I'm your host, Doctor Anne
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  Gonzalez, and together we'll explore the wins, the struggles,
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  and everything in between. Let's dive in.
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  Hi, and welcome back to DPC Life, the podcast where we talk
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  about all things DPC and life beyond the office.
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  If doing QuickBooks over the weekend feels like pulling
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  teeth, then this episode is for you.
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  Today I'm talking with Nate Goodman, CPA and also DPC
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  patient who built his firm to serve direct primary care
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  doctor. Specifically, we get into when
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  to bring in an accountant, how to use a simple scorecard every
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  week to know how your practice is doing, and then how you know
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  if your numbers show your DPC is working, that you're actually
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  making money, or if you need to change something.
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  Before we get into the episode though, if you have been
• 1:40
  dreaming of DPC or are in your first year and want a simple
• 1:45
  road map, I put together A5 day DPC Confidence course that walks
• 1:50
  you through some of the big decisions and tries to make it
• 1:53
  easier to take a little step every day.
• 1:56
  So to get that, just DM the word course to me on Instagram and I
• 2:01
  will send you the link. So let's get into today's
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  conversation with Nate Goodman. Today my guest is Mr. Nate
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  Goodman, CPA, and he's located in Black Mountain, which is
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  really like an hour away from me.
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  So that's pretty awesome. And so Nate is here to talk
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  about his accounting practice, Who he's found DPC somehow.
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  Why don't you start out by telling us how you found DPC?
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  Yeah. So I was with ACPA firm in our
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  town of Black Mountain and Doctor Height, one of our
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  clients, he called me had a referral from a from another
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  like financial planner and just said hey, there's an account in
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  time to talk to him. And so I called him or he called
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  me and I started kind of walked him through our process and I
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  was like, well, tell me a little bit what your business is and
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  how you do primary care. And you know, well, people pay
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  us a monthly fee and we're ultimately seeing like better
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  health outcomes because of that because people are coming to us
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  more regularly. And my wife and I were on the
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  alternative healthcare journey back starting in 2019 when I
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  became self-employed and realized that going to the
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  marketplace and buying health insurance was not going to work.
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  It was astronomical and the benefits were terrible.
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  We started working with the health sharing group, but we
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  never, I never went to a primary care doctor because I was like,
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  well, I don't want to pay that out of pocket.
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  And so when I heard his model, I was like, that is a perfect pair
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  with my health share. Because now it's like I'm still
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  only paying maybe 500 bucks a month for my family's health
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  insurance, which is this health share plus the DTC membership.
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  And I get my labs and I can go whenever and a kid falls and
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  scratches his knee and then stitches, he can do that.
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  And I was like this, this is great.
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  So after that, we just kind of went head first over figuring
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  out what this DTC movement is, how far down the road it is, and
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  asking now opinions of other DTC doctors of what do you need in
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  accounting? You don't want to probably hear
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  from your accountant that regularly.
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  If you do this, most likely a problem, but when you do call
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  him, you don't want to get charged every time you call him
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  and you also want to get a response pretty quickly.
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  So I sent you an e-mail. Why didn't you respond in, you
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  know, a week or two that's too long, like you need a 24 or 48
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  hours so that his process in like seeing how he did primary
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  care. I finally went and saw a primary
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  care doctor for the first time. And so super helpful patient, a
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  DPC patient. Right.
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  I'm a DPC patient and we're actually forcing all of our
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  staff to get on a DPC membership.
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  Wonderful, yeah. Because they all work with DPC
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  doctors. So we're like, you need to know
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  what this feels like. And I know Doctor Shane Purcell,
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  he we bought a bunch of his books and put them in our office
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  for people to read that the good care feels different.
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  It's like the little kids book that shows.
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  What? DPC.
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  Is his new book right? Yeah.
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  Great. I love what what they're what
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  you guys are doing and we're just trying to play our part in
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  the movement now. So I know one of our team
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  members, they started going to a DPC member, DPC, the same
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  doctor, and obviously like they were running panels and like
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  they sat down and talked to her for an hour, right?
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  Because y'all's appointments are so much longer.
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  And as a part of that appointment, they talked about
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  she was having issues with thyroid.
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  And we said, man, that when she talked to the doctor for an
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  hour, they were able to figure out like, hey, have you tried
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  just changing your diet, right, Instead of putting her on some
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  sort of prescriptions and all these issues.
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  And they were able to identify the root cause.
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  And now all she's had to do was adjust her diet.
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  And it's like she's living like the healthiest she's ever been.
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  And so seeing it impact my own team has also just continued to
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  reinforce why I believe so much in what you guys are doing.
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  Well, that's great. So once you learned about DPC
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  and saw what Doctor Heights doing, it just got the wheels
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  turning for your own business. Is that right?
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  Yeah. So we, I'd always been doing
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  bookkeeping payrolls and like tax planning and advisory and we
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  were doing tax preparation to some of the necessary evils of
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  our industry. And I just realized I hate what
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  as people started to, I met more DTC doctors, I started to hear
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  the pain that they were having with finances because a lot of
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  them were like, I got into this to just have some better work
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  life balance and do the thing that I love and get into this to
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  run a business. And, but now I'm having to run
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  this business and it feels like I'm pulling teeth trying to do
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  my QuickBooks every weekend and I'm stressed because I don't
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  know how my business is doing. So I was like, well, what if I
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  came in and worked with you monthly and you can ask me any
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  questions anytime, all the time and I won't charge you any
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  extra. What will this agree on a
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  monthly fee? And they're like, that's great.
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  Well, that's amazing. So, so you have a monthly fee
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  and is it kind of like other DPCS?
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  Well, at least our DPC, we have kind of like age tiers.
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  Do you have anything like that or is it just flat doesn't
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  matter? Like by size, Yeah, we have like
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  a, we have a size matters and team size matters.
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  Micro clinic won't pay as much as a multi site clinic with 20
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  doctors because that's going to have a lot more compliance needs
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  and payroll needs. There's also we have a good,
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  better, best model where our good is, hey, if you want just
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  the basics, you want bookkeeping and you want facts preparation
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  and planning and like, or maybe you want a little bit more help
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  from one of our CF OS and they work with you quarterly to a
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  business plan and do strategy. And, and then from there you can
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  meet with ACFO monthly and they're really budgeting,
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  forecasting in real time, talking strategy every single
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  month. And usually it's geared for
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  different needs for each of those doctors.
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  Like some doctors are like trying to grow, they want to add
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  providers and other doctors are like, I just want to, it's going
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  to be me and I want to be sustainable.
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  I know that I'm doing OK. So we try to craft it around
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  what we've heard from people or what they need.
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  For example, like if someone was just starting and they're
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  thinking about, OK, I want to do this when, when's the best time
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  to talk to an accountant When you're starting out, when you
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  get 6 months in, what? What would you suggest?
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  Yeah, we identified this as a problem too, or asked around.
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  That's kind of like, hey, and now that you're six months in,
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  we ask most of our existing clients that are running TPC
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  practices, What do you wish you had right?
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  What do you wish you had done six months before?
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  A lot of them were like, I wish I just had some clarity around
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  like a budget had some clarity around like what entity type was
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  right. Social media is full of advice
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  on you should be an S Corp and don't pay yourself a salary.
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  Hire your kids and you can get down this rabbit hole of tax
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  advice. So we then kind of went into the
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  the whiteboard and started thinking of what kind of
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  launching service could we provide that would help address
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  these specific questions that people have had.
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  And so I think 6 months before is probably a good time to start
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  the conversation with an accountant because they're going
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  to have an on boarding period. It's going to take them time to
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  get you set up. If you're six months in and
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  you've been running a practice, then you've got books to clean
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  up and things to do if you haven't been doing that.
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  And so if they start on a good foot before that first
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  transaction ever hits your bank account, you know you've already
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  built that relationship with them, so they're ready to help
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  you get started. Yeah, so we did.
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  We've created something called the Launchpad, which is
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  basically 2 consultations and video training, like self-paced
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  video training to help people. They want to manage their own
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  QuickBooks. We teach them how to do it at
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  least gives them some base knowledge of how to read your
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  own financial statements, how to build a budget, how to build a
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  cash flow forecast. And we have templates and stuff
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  that people can then use to go in and build those things.
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  And they can either do it themselves or they can use those
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  consultations as like a working meeting to help put that stuff
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  together. Do you do 1 off?
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  Kind of consults. Or is it always built into a
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  membership type? Just because of the my most for
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  the industry, what people are doing, I've always just told the
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  doctors, we went to the DPC summit this last year and
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  everyone I shook hands with, I was like, if you give me if you
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  don't want to work with me, that's totally fine.
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  But if you're looking for an accountant and you want me to
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  help you, then look at their proposal to give you some
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  questions to ask. I was like, just shoot me an
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  e-mail like I would love to help you.
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  Because what I care more about is that the DPC industry
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  succeeds. And we've talked a lot about
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  this as our team and our mission as we grow of helping to build
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  sustainable practices. Because I've talked to, I've
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  gotten the opportunity to talk to one doctor this last year.
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  He basically hopped on the call with me and just said, I think I
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  need to close. Like I have not profitable, it's
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  not working. I said, well, let's like look at
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  your books together and let's pull this up real quick.
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  And we worked through his numbers.
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  And, you know, at the end of that meeting, we were able to
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  then determine he made $80,000 his first year in running his
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  DPC practice. I'm sure that's not a doctor's
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  salary at a, at a hospital, but it's a business that's
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  profitable. That was a huge win.
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  And he walked away being like, I could keep running this.
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  I was like, please do, don't close.
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  Oh. No, that's terrible that he was
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  thinking he like had to close. I thought he had the the last
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  account that he had and basically told him like, hey,
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  you're not, it's not going to work.
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  It's you're not making enough money.
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  And I just said, well, let's just look at the data and I'll
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  help you read it. Let's not once you understand
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  it, it starts to make sense. It's not probably like medicine.
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  Medicine feels like A to be like a dark hole that I will never
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  fully understand but. So that particular doctor, I
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  wonder, his accountant that he had before wasn't familiar with
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  direct primary care. I.
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  Guess, yeah. And I guess for maybe a
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  traditional primary care office, maybe that would be a problem.
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  But yeah, I think I've heard a couple other good things this
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  year. One was from the director of
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  sales at Hint. And he was saying, I was like,
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  what are you guys like, what would you say about what?
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  Why? What makes you different?
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  And I love that He was like, the big thing to look for DPC
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  doctors is if you believe in the movement of what you're doing,
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  look for vendors and people that you want to work with that are
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  also investing in the industry. Like they're trying to think of
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  ways to help make your job easier, right?
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  So if we use, I'm guilty of this in the accounting field of
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  choosing our task management software that we use as just a
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  general software. But there's companies that make
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  stuff specifically for accounting.
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  So if I put my money with them opposed to just the general
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  everybody, they're gonna make the accounting industry better.
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  And I really like that. I like why wouldn't we invest in
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  the things that help promote the growth of the industry?
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  I'm rambling a lot, sorry. Oh, you're fine.
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  This is this kind of like our my podcast is just very much like a
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  coffee chat. And so it goes.
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  On I love. Wild chat tangents and we'll try
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  to rope back but OK so. Where's your practice located?
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  I'm in, we're in Hickory. The main office is in Hickory
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  and then Satellite in Morganton because I live in Morganton, so
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  I'm in. I met Doctor Height at the
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  Mastermind in Greenville right before we opened and he opened
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  like a month before we had. And so just that's how we became
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  friends because we were just geographically closed, so.
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  That's very cool. I'll say I've met Doctor Mehta.
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  Oh yeah. I've met another, I don't
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  remember the name. Doctor Spring, Maybe Springston.
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  Springston Yeah, yeah, yeah, yeah.
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  I feel like I've met a lot of people from y'all's masterminds
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  just by going to like the different conferences and stuff,
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  but. Yeah, You know, I think I
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  remember when Doctor Height and I were at a mastermind that
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  Doctor Mehta hosted, and he is telling me that he told Doctor
• 14:00
  Mehta about his new accountant. So that was you.
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  Oh. That's funny, yeah.
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  Yeah. I don't know if you've heard
• 14:07
  about this if since you've been part of that group, but the
• 14:09
  Goldman Sachs 10,000 small Businesses program that people
• 14:14
  are doing like learning about business.
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  And as we've heard about that and heard other DPC doctors
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  doing it, we kind of said what if we crafted a similar course
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  that people can apply to and it would just be a way to help
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  people get Better Business acumen.
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  I'm curious, have you done any courses like that as you stepped
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  into being a or any sort of like business training to as you
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  stepped into owning your practice, what your process was
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  for? Yeah.
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  So, well, when we started, we read all the books and then I
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  did the mastermind and then I've just been like doing these kind
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  of like, I don't know, members, I don't know what you call a
• 14:53
  subscription membership kind of things online.
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  Like we have a, our side kind of second business is aesthetics.
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  And so that part, honestly, the DPC part, it's pretty simple.
• 15:06
  I mean, you know, it's, it's very easy.
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  There's one thing and it's just, it's very simple.
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  But the aesthetics part that requires a lot more attention
• 15:17
  and it wears a lot more really business stuff behind it.
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  So I've been doing these kind of groups and communities where
• 15:26
  it's more like Med spas and spas type business, which has been
• 15:31
  super helpful. I haven't done any particular
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  one thing like a directed full on course.
• 15:39
  It's been more smaller things like that.
• 15:41
  I have looked at the 10,000, what is it?
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  I don't know 10,000. Small businesses.
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  Small businesses, yeah, I just like the timing didn't work out,
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  but yeah, that's a really interesting idea.
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  If you did something like that, I'd definitely be interested.
• 15:55
  Because that stuff is it's. Hard to learn.
• 15:58
  And so that's one thing like with the podcast and that I've
• 16:02
  started doing is like some little just like coaching
• 16:05
  podcasts because it's hard and it and again, it's either you
• 16:12
  paying money or you paying time. And especially if you're
• 16:17
  starting a business at 50, for example, I'd rather paying money
• 16:21
  than I wouldn't pay in time because there's not much you
• 16:23
  don't have that much time, right.
• 16:25
  So I've been doing some of that and it's really interesting.
• 16:27
  Like people are the messaging is one thing that that definitely
• 16:33
  it's hard because when you come out, you want to serve everyone,
• 16:36
  right? Because you don't know you're
• 16:39
  kind of like, well, who who wants what?
• 16:41
  And so it just ends up being this whole confusing mishmash of
• 16:46
  everyone. And then there's all these
• 16:47
  things about like, problems with boundaries because doctors have
• 16:50
  no boundaries. Yeah.
• 16:54
  So, yeah, there's a lot of things that I think something
• 16:57
  like the Goldman Sachs would be nice because that's you hear it,
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  but it really has to be kind of pounded into your head and not
• 17:06
  just hear it, but you have to practice it almost like you have
• 17:09
  to literally like just say it over and over and work with
• 17:16
  somebody who was, was it, I don't know, maybe it was story
• 17:20
  brand guy Donald, what's his name, Donald Miller.
• 17:23
  Yeah. Yeah, like he's, he was talking.
• 17:26
  He was talking about somebody who was doing sales.
• 17:28
  Maybe it was him. It was him or Harmozy, I don't
• 17:31
  know. I'd listen to all these people.
• 17:33
  So, yeah, but this guy was doing sales training and he would
• 17:36
  listen on calls and he's OK. Do it again, Do it again, Do it
• 17:41
  again. Yeah.
• 17:42
  Because you just got to, you just got to say it.
• 17:44
  And the more you say it, as this becomes ingrained and it's not
• 17:47
  so hard. So that's one thing that I do
• 17:50
  with new, newer DPCS. And what's your elevator pitch?
• 17:55
  Tell me. Yeah.
• 17:57
  And say it again. Say it again.
• 17:58
  Yeah. Practice it.
• 18:01
  But anyway, yeah, so back to yeah, that would be really cool.
• 18:04
  What would you what would you include in something like?
• 18:06
  That yeah, so and maybe this plays into the other idea that
• 18:09
  we're getting ready to roll out. So I'm a big fan of online
• 18:13
  communities. I don't know if you said you're
• 18:15
  part of those paid kind of like Med spa.
• 18:17
  Yeah, yeah. People that talk about business
• 18:18
  models and things like. That.
• 18:19
  Yeah. So we're actually in the
• 18:21
  process, hopefully to launch beginning of January, a DPC
• 18:25
  based community that is more curated than like the Facebook
• 18:30
  community. Sure, I know the Facebook
• 18:31
  community is a great place, wealth of knowledge.
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  It's also like a free for all, right?
• 18:35
  There's a lot of stuff in there. And then there's communities
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  that are based, that are plugged into a software or a company
• 18:40
  that you know, you're paying for their software.
• 18:43
  And So what we've looked at planning to do now is to build a
• 18:47
  community that includes a portion of courses that like,
• 18:50
  and there's some resources in here that you get.
• 18:53
  The other benefit is going to be the shared knowledge in a
• 18:57
  curated environment. So like people who are just
• 19:00
  starting getting to be in a group with those that has a
• 19:03
  mentor similar to a mastermind, but then the people who are
• 19:06
  established having a group that's OK, this is the the five
• 19:09
  year plus page, like people back in five years plus.
• 19:12
  Those problems look a lot different than the people
• 19:15
  starting out and then having member only content sessions
• 19:20
  where it's asked me anything. So bring all your accounting
• 19:23
  problems and just because you're part of the community, we're
• 19:26
  going to work through those problems and anybody can come in
• 19:28
  and watch us talk through your problems.
• 19:31
  Another thing we talked about was maybe like roast my DPC.
• 19:34
  So you come on and the person tells about their DPC practice,
• 19:38
  their pricing model, their how they pay people.
• 19:40
  And we just sit there and talk about all the ways that we've
• 19:43
  got to do stuff differently. And then the other big part to
• 19:47
  that is, hey, we're going to do business training and this is
• 19:50
  going to talk about we're going to go just all the whole
• 19:53
  session, we're just going to talk about your profit and loss
• 19:55
  statement and something that you're like, I don't would never
• 19:59
  read a book on this. So it sounds so boring, but be
• 20:01
  able to create an engaging session that we can talk through
• 20:04
  issues and problems related to business, running your business
• 20:08
  and what to monitor and just have like recurrence of those
• 20:11
  are the rituals or the rhythms of the group.
• 20:14
  So that's something we're planning to to look and launch
• 20:16
  into as well as in there we'll do.
• 20:19
  Like availability for support with tax stuff.
• 20:22
  So if you have need help with your, you've got your own CPA,
• 20:25
  but you're looking for somebody who knows the DPC model to
• 20:28
  answer some tax questions or strategy questions having all
• 20:32
  that kind of built into to 1 model.
• 20:35
  So I think what would be in that business course?
• 20:37
  I'm brainstorming live here. Yeah, sure, go for it.
• 20:41
  Yeah. I think it's really that it's
• 20:42
  understanding your financial statements.
• 20:43
  So that's a block understanding how to do KPIS&KPIS.
• 20:49
  Like I've read a book called Tractions, you really want to
• 20:51
  have a scorecard that on a weekly basis you could tell if
• 20:55
  your business is on or off track.
• 20:58
  And so it's like what is that for DPC, right?
• 21:00
  What are some of those metrics that are not financial?
• 21:03
  It's hey, how many employees do we have?
• 21:05
  How many patients does these, if our physicians have, how much
• 21:08
  cash did we collect last week? What is our marketing?
• 21:12
  Do we have 10 leads or potential patients coming in every week or
• 21:16
  five or two or one? Those metrics, if you're not
• 21:22
  hitting them, it'll be very clear that you're not going to
• 21:25
  make it right. So like, so whatever your goal
• 21:28
  is. So kind of talking about how to
• 21:30
  interpret KPIs and set KPIs. Churn Google reviews.
• 21:37
  Churn Google reviews, yeah, yeah, I love that.
• 21:40
  And then talk about looking forward.
• 21:42
  So like forecasting and how to do really simple forecasting
• 21:47
  because that term I think is really intimidating to be like
• 21:51
  how do I building a forecast that sounds like I need ACSO or
• 21:54
  finding a person that does FPNA all the time?
• 21:56
  Crystal ball. Yeah.
• 21:59
  And I tell people like, the best thing you can do is just do it,
• 22:02
  put one together. But let's show you a really
• 22:04
  simple way to do it and then you have something to make decisions
• 22:07
  on. Can I spend $10,000 this month
• 22:10
  on this new set of inventory that I need for this new
• 22:13
  business line? And well, this is how much of it
• 22:16
  you'd have to sell to break even.
• 22:19
  And I did that yesterday. I was in a like a launch fruit
• 22:22
  that was getting ready to launch their practice.
• 22:23
  And we were looking at it like, hey, if we put bought a $10,000
• 22:26
  medical table, like First off, don't do that.
• 22:29
  But you did, you bought it in January and you would run out of
• 22:33
  money in April. But if you bought it in May, you
• 22:37
  would make it, right. And it's a very interesting to
• 22:40
  say when I can spend money or when I can hire people.
• 22:44
  A forecast that's dynamic like that gives you the ability to
• 22:47
  make decisions and give you that freedom is my thing.
• 22:51
  I really want DPC owners to be free to go and practice and not
• 22:57
  stress about their decision. Making SO question like our
• 23:01
  practice, we have the aesthetics as well.
• 23:05
  Do you work with practices who have this kind of multiple
• 23:08
  pieces? I feel like every single one of
• 23:10
  them has it almost, I don't know many that are just really pure
• 23:15
  DPC. And like until they reach a .1
• 23:19
  of our doctors is getting to the point that he's, I'm just going
• 23:21
  to, he was offering other services and he's now kind of
• 23:23
  cutting those out because they have about 800 patients on their
• 23:26
  panel. And he's got, it's him and APA
• 23:29
  and he's got medical stat like a medical assistant and office
• 23:33
  manager. And it's a now if he cuts that
• 23:36
  stuff out, it allows him to focus on the most profitable
• 23:39
  part of his business. But we do have people that do
• 23:42
  the aesthetics and we talk about, hey, you bought X amount
• 23:45
  of inventory and we got to try to use it up and, and make money
• 23:49
  on it. So if we're not generating the
• 23:51
  interest from the community, we need to put some marketing out
• 23:54
  there and show people that we do this.
• 23:57
  Yeah, or people will do like health coaching, fitness
• 24:00
  training, a lot of people that we found a lot of success in
• 24:04
  that doesn't really require a lot of heavy investment is the
• 24:07
  professional exam examinations. So like flight pilot's need
• 24:11
  examinations, firefighters, executives, there's executive
• 24:15
  exams, those types of things. Those are great little pieces to
• 24:19
  hot kind of boost the cash on the end.
• 24:21
  Sure, what other tips do you have for starting out DPC think?
• 24:25
  This is big for me starting my own business.
• 24:27
  I think this is a business tip in general, but we don't take
• 24:32
  the time to think through like what would we want life to look
• 24:34
  like in 10 years or five years, some long term like plan, right?
• 24:40
  And until recently when I actually sat back and looked at
• 24:43
  that and said Oh well, I want to work with 1000 DPC clinics in 10
• 24:48
  years. We want to be able to have
• 24:50
  enough volume that we can provide insights into the
• 24:54
  industry from a finance perspective.
• 24:58
  And when I started to set that goal, I thought about, well,
• 25:01
  what does that look like impact wise, right?
• 25:04
  Are those 10 or 1000 BPC clinics sustainable, growing, just those
• 25:09
  owners feel free to do what they do.
• 25:11
  So talking to owners to say, hey, First off, just just take a
• 25:15
  minute to like maybe get out in nature, take some deep breaths,
• 25:19
  take a notebook with you. It's like, what do I want my
• 25:23
  life to look like? And you long term goal setting,
• 25:26
  I know there's controversy over that.
• 25:28
  People don't always agree on doing it.
• 25:30
  But if you set that kind of idea in your mind of this is what I
• 25:34
  want, I want a 30 hour work week or I want to be able to sit down
• 25:37
  with my patients and I want to sit down with 300, not 3000 that
• 25:41
  then you can start to back into, well, what do I need to do 3
• 25:46
  years from now or where do what I need to be?
• 25:48
  And if I need to be there in three years, where do I need to
• 25:51
  be a year from now? And so I need to be there by
• 25:55
  next year. What do I need to do this
• 25:57
  quarter? And now you have action steps
• 26:00
  that kind of take you to the long term goal.
• 26:04
  I think that is a huge kind of first step for people starting
• 26:07
  out that they start forming their entity and taking all
• 26:10
  these courses and getting all these things and pet and
• 26:12
  spending all this money and talking to all these people.
• 26:14
  And there's information overload that if you were to, if everyone
• 26:17
  were to take a step back, be like they just wanted to be a
• 26:19
  micro clinic, if you just wanted to be a micro clinic and instead
• 26:24
  of spending that money, well, you could have just kind of
• 26:27
  taken one thing and said this fits for my specific goal.
• 26:31
  And then that kind of talks about, we talked like how many
• 26:33
  patients do you want to see? I think it's really important
• 26:35
  for people to kind of gut check themselves on pricing by saying
• 26:39
  how much do you want to make and how much do you have to make,
• 26:43
  right? If you have to make $100,000 to
• 26:46
  pay for your family's bills, then day one, what would you
• 26:52
  need to charge? Just how many patients could use
• 26:54
  possibly see in that first year? And so we do a pricing
• 27:00
  conversation and I think I, I look at pricing three ways from
• 27:07
  the folks that we've gotten to talk to.
• 27:10
  I look at, and this is maybe different than the normal, I
• 27:13
  look at the the census data and say if you look at the family's
• 27:19
  household income in your area, on average people spend almost
• 27:24
  12% of their annual household income on healthcare.
• 27:29
  And so we kind of say, well, what if they instead spent that
• 27:31
  money on DTC and a health share? Then they could spend 5% or 10%
• 27:40
  and save the 2%. And then you could say, well,
• 27:43
  what if I charged my fee for a family of four as 5% of the
• 27:48
  household income in my area? So Buncombe County where I live
• 27:53
  is like a $95,000 family household income.
• 27:57
  So then a doctor would charge maybe $5000 a year for that
• 28:01
  family of four and it usually boils out to 100 or $120.00 a
• 28:05
  month per individual. That's one way we look at
• 28:09
  pricing. The second way that we look at
• 28:11
  pricing is typically a market research.
• 28:14
  Do you have any DPCS in your area?
• 28:16
  And that's usually when we'll talk about this zip code base is
• 28:19
  if you don't have any in your area, it's kind of hard to even
• 28:21
  know what to stick that at. And so that helps kind of
• 28:26
  eliminate the pricing fear of pricing too high or too low.
• 28:30
  Market research is helpful. One of the DP CS around you
• 28:32
  charging, one of you are going to serve every resident in your
• 28:35
  community. So you don't have to worry about
• 28:36
  competition, at least not at this stage.
• 28:40
  And and then that third one is the what do you have to make and
• 28:44
  what do you want to make, right? Because you could also charge
• 28:47
  based off of that. I want to see 300 patients and I
• 28:49
  want to make $300,000 a year. That's my cap.
• 28:51
  And so you're like, well then you don't have to charge this
• 28:53
  much per month. And so you got to work on your
• 28:57
  elevator pitch and your marketing to identify that maybe
• 28:59
  higher net worth individual that's willing to pay that per
• 29:02
  month for that access. Those are That's 5 tips in one.
• 29:08
  That's fantastic. I'm going to have to go go back
• 29:10
  and listen and take each one piece by piece.
• 29:12
  The first part that you were talking about, like thinking
• 29:15
  about what you want in five or ten years.
• 29:17
  That's fantastic because that and that's a hard thing to do
• 29:21
  because when you start out, you're just a lot of people are
• 29:24
  just like, I just want to get out.
• 29:25
  I just want to get out of where I am and they don't really think
• 29:29
  about. And the other thing is like,
• 29:31
  what are you? What are you earning the money
• 29:33
  for? Which is like you said, you need
• 29:34
  100,000, for example, to support your family or whatever exactly
• 29:40
  you want to spend that money on. Is is important too, because a
• 29:43
  lot of times people are like, I want to make 200,000.
• 29:45
  Well, why? Yeah.
• 29:47
  For what? What exactly?
• 29:49
  I mean, they have needs, but they just need to think about it
• 29:53
  so that those are great. So you're thinking about opening
• 29:56
  up these communities soon? Yeah, We've been in the asking
• 30:00
  the doctors phase of what would you want in a community.
• 30:05
  I would love to hear from more people.
• 30:06
  I try to ask every doctor that I've come in contact with from
• 30:09
  the DTC side of like, why would you ever join one?
• 30:12
  Why would you join one? That's not the ones that are
• 30:14
  already there, right? Is there something missing in
• 30:17
  those communities that you would like to see?
• 30:19
  What would you want to see in a community that you found
• 30:21
  beneficial or would you find beneficial?
• 30:25
  Well, I, I mean, the Facebook groups, of course, are, are
• 30:28
  wonderful. They're free, right?
• 30:30
  They are large and like you said, a little bit of a free for
• 30:34
  all depending on some of them are more so free for all than
• 30:37
  the others. But they were large.
• 30:39
  And so it's just a lot of stuff to wade through.
• 30:42
  And it's as the movement has grown and as more people have
• 30:45
  gone into DPC it there is a lot. It's truly like fire hose with
• 30:51
  the information. So that takes a lot of time to
• 30:55
  wade through that. So I'd like the idea of the
• 30:57
  curated kind of smaller community.
• 31:01
  And the other thing that's been really helpful when with these
• 31:05
  other kind of like Med spa type communities is.
• 31:10
  They have calls like. Once a week and it's just for
• 31:15
  the members and so there's they'll have Monday at noon,
• 31:19
  Tuesday at 1, they're set times and then they have moderators
• 31:23
  that will be on there. And each month there's a topic
• 31:26
  like working on sales for retail or like employees hiring people.
• 31:33
  So each month has a topic. And so you can just hop on to
• 31:36
  whichever one, which is really cool.
• 31:39
  And so they're sometimes it's the same people in there and
• 31:42
  sometimes it's different ones. But those have been great
• 31:45
  because if they're not very big, I mean there's only three or
• 31:47
  four people usually. And so we talked about where we
• 31:50
  are, what's going on, how business has been, how, oh, it's
• 31:55
  Black Friday's coming up, who's got specials, what are you
• 31:57
  doing, what have you seen in the past?
• 31:59
  How does that, how has that worked?
• 32:01
  So things like that have been really nice.
• 32:02
  And it's just cool to, to meet other people who are doing the
• 32:05
  same thing and knowing that you're not alone.
• 32:07
  Like everyone is dealing with the same issues and struggles.
• 32:12
  So it's kind of self selects because the people who are in
• 32:15
  these groups, of course are the ones that need help.
• 32:17
  So you're going to be you're going to meet the same kind of
• 32:20
  people, which is nice. I guess that's why they all kind
• 32:23
  of have the same issues. But it's been helpful.
• 32:26
  So and just getting ideas. That part has been really
• 32:29
  helpful. So that's what I've liked.
• 32:30
  They have these big kind of monthly longer like calls with
• 32:36
  the women who started the whole thing.
• 32:38
  She'll have she owns the company, so she'll have a 2 hour
• 32:42
  kind of deep dive into something.
• 32:44
  So I think recently it was sales and then I don't remember some
• 32:49
  of the other ones, but you know, like every month there's a big
• 32:51
  kind of deep dive you can get on.
• 32:53
  It's a Zoom call, more people, I think because it's a bigger
• 32:57
  monthly one. There's more people on that one
• 32:59
  particularly usually, but they have a central kind of community
• 33:06
  where there's a calendar and then there's resources and then
• 33:09
  there's the like the communities like chat kind of communities
• 33:12
  too and different just like you said, esthetician only or Med
• 33:17
  spa or different topics, kind of like the five year clinic or
• 33:22
  like you're talking about. Yeah.
• 33:24
  So those are nice. I like that our goal is like not
• 33:27
  to. We don't want any bias in it,
• 33:30
  right? I think that's what we're trying
• 33:31
  to push towards is you don't have to buy anything, right?
• 33:36
  It's like we're not trying to push you constantly towards
• 33:38
  buying something in this group. The goal is that there's helpful
• 33:43
  information about lots of different topics within DPC,
• 33:49
  right? Choosing your EMR, choosing your
• 33:51
  practice management software, you're the ones that we know of
• 33:54
  and here's price points that we've seen and here's the pros
• 33:57
  and cons and here's why people would choose one over the other.
• 34:00
  Here's marketing people that we've talked to that, here's
• 34:03
  ones that specialize in DPC and here's ones that are just
• 34:05
  generalists and marketing that why would you need them and
• 34:09
  would you like who needs them, What types of people so.
• 34:11
  Yeah, yeah. So would people be able to do
• 34:14
  the community without being one of your clients or it's all?
• 34:18
  One, yeah, that's the goal, OK. Yeah.
• 34:20
  That they wouldn't have to be a client of ourselves if they had
• 34:22
  their own CPA and they wanted to be a part of a shared community
• 34:27
  that's getting help. We'll try to stay on our lane.
• 34:30
  We're not trying to teach people how to do stuff we don't know
• 34:32
  how to do, but bringing in experts as we can.
• 34:35
  And my other goal is to have some other founding members that
• 34:38
  are DPC doctors that can speak into the community.
• 34:42
  That way we're not trying to address issues that aren't real
• 34:44
  issues and also be there as, hey, if you're part of it as a
• 34:48
  founding member, you're also there to support and be a mentor
• 34:51
  to people through structured groups and stuff that, you know,
• 34:55
  you'd get a, a free membership or whatever to the community to
• 34:58
  be able to be a part of that. Yeah, well.
• 35:00
  It sounds, it sounds very intriguing.
• 35:02
  I think a lot of people would be interested because the business
• 35:05
  part's real hard, of course, for most.
• 35:08
  Yeah. So, yeah.
• 35:10
  All right, I. Was taking.
• 35:12
  I was taking notes as you were talking because I was like, all
• 35:15
  good stuff. Extra feedback, yeah.
• 35:18
  Good. Well, I'm glad it's helpful for
• 35:19
  you. Well, thank you so much.
• 35:22
  I appreciate your time. So how can people find you?
• 35:27
  We have a website wejustfinishedpurchasinga.combecausewewerea.llcbutyoucanfindus@goodmancpa.com
• 35:36
  or you can find us at Goodman CPA dot, LLC.
• 35:40
  Both still work and get you to a website butwedohavea.com now
• 35:43
  because that was getting confusing.
• 35:44
  Yeah, yeah. That's.
• 35:46
  Hard people can also shoot me an e-mail, like talking about those
• 35:48
  consoles that people like him. I've got some questions.
• 35:52
  You can shoot me an e-mail. It's just Nate at Goodman CPA
• 35:56
  LLC. Great.
• 35:58
  But yeah, if you go to our website, we have a whole kind of
• 36:00
  landing page that talks about our direct care, how we work
• 36:02
  with direct care and yeah, all that's in there so.
• 36:05
  OK, perfect. Well, thank you so much for your
• 36:07
  time. I appreciate it.
• 36:08
  And yeah, I hope listeners, if they have ideas for this
• 36:12
  community or other things that Nate can offer and his
• 36:15
  subscriptions for DPC offices, that would be great.
• 36:18
  Just post them in the comments or just shoot them an e-mail.
• 36:22
  So great. Well, thank you so much.
• 36:23
  And I hope that we'll get to meet in person soon, because
• 36:26
  we're not very far apart, I'll say.
• 36:30
  We should grab a coffee soon. Yeah, yeah, I know.
• 36:32
  I need to go visit W sometime anyway so that would be good.
• 36:36
  I hope that this conversation with Nate took some of the
• 36:39
  mystery out of your numbers and also helped you realize that you
• 36:43
  don't have to do everything alone.
• 36:45
  So to help you out, I created a free five day DPC Confidence
• 36:49
  course. Every day you'll get an e-mail
• 36:52
  with just one small step to get you closer to opening your own
• 36:56
  DPC practice. In order to get access, DM the
• 36:59
  word course to me on Instagram and you'll get the five day
• 37:03
  e-mail series. And if you really enjoyed
• 37:06
  hearing Nate's perspective, share this episode with a DPC
• 37:11
  friend who is still wrestling with QuickBooks.
• 37:14
  Thanks for listening and I'll see you in the next episode.
• 37:19
  Thank you for. Listening to DPC life.
• 37:22
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• 37:27
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• 37:29
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• 37:32
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• 37:37
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• 37:41
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