Do DPC Physicians Get Overwhelmed?

Is DPC really that good for me as a doctor? What about offering "Unlimited" appointments? Do I have to be available 24/7? Won't being on-call overwhelm me? The short answer - it's better than you think. Here's the reality of being a DPC physician...

You control the model and the schedule

Owning your own practice as a DPC physician (or Direct Specialty Care) allows you to build the practice that fits your schedule and strengths.

As a primary care practice, do you have to offer unlimited office visits, 24/7 on-call access, and lengthy office visits to members?

No, you don't have to.

But before you decide against it, here's how DPC is truly different.

You can offer those 'unlimited' services and enjoy vacation, time with family, and have a life in general.

I promise.

The main limiting factor - patient panel size

The average family physician in the United States has around 2500 patients in their panel. I've known some with over 4,000.

The average DPC physician? We don't know the exact numbers, but it's closer to 350-400.

Most physicians feel quite comfortable (time spent with patients, time away from the office, and financially stable) with around 400 patients. Some desire more patients (I've seen up to around 1,500), and some desire less (you can still run a financially stable business with 250 members).

The great news is that you can decide what the best balance is for you.

Unlimited appointments - the reality

When patients sign up as members, they're counting on having access to a physician. A DPC membership is offering them access, stability, peace of mind, and a physician that is for them.

What typically happens: new members will see you 2-6 times in the first 6 months of membership. Then, unless they're dealing with a chronic issue, they'll slow down and you'll see them once every 4-6 months. Why? You've shown that you're actually available when they need you and you've taken care of their neglected health. In short, DPC has worked for them!

Once everything balances out, the math usually works out like this: for every 100 members, you'll see 1-2 members per day if you work a typical 4-day workweek.

So no, you won't have to worry about being overwhelmed if you offer unlimited appointments!

24/7 access - will you get slammed on nights and weekends?

The short answer - no. You won't get slammed on nights and weekends. Trust me.

Why? A few reasons:

• Your patient panel will be smaller
• You have taken their calls during the day (and often either seen them or talked with them already), so they won't bother you at night
• Patients still respect your time, so they won't call after hours unless they have a true emergency (or you can train them if they don't know what an emergency is)

A real-world example... when first opening our clinic, the first year we averaged around 400 members, and had a total of five phone calls after hours the entire year. Not per week. Not per month. Five calls the entire year!

DPC actually works - because you have a closer relationship to your members, they will respect your time, which means they won't wait to call until it's late in the day.

Do I have to offer 24/7 on-call service?

No, of course you can set up your business how you wish. Several DPC physicians have set a boundary that they won't answer after-hours calls, and if there are any urgent needs after hours, members are encouraged to go to urgent care or the emergency room.

However, I will say that the peace of mind that comes with 24/7 on-call access is a tremendous value when it comes to DPC membership.

If you don't want to be on call yourself 24/7 but still want to offer that as a service to members, there are a few options:

• Hire another physician or mid-level provider for when you want to go on vacation for after-hours calls.
• Pay a nurse hotline service to triage calls.
• Don't offer 24/7 on-call until you have other providers working with you to split call.
• I'm not sure if this exists yet, but you could likely train an AI assistant to triage calls and/or chats after-hours, so you only receive the important calls - or are able to send people to urgent care via an AI chatbot / voice assistant if their condition reaches a certain threshold.
  • Technology is moving so quickly - if you don't know of this service, message me or join our Skool group (link at the bottom of the article), and let's figure this out if you're interested!

DPC will be a relief...

Whether you're considering opening your own practice or joining another, DPC is often such a relief for physicians. The pace is less stressful. You get the pleasure of practicing your entire scope of medical training, and you get to actually help patients that need it.

It's rare that a physician who works in the traditional system that converts over to DPC ends up working more than they expected.

Will you get overwhelmed? I can't guarantee you won't - but it likely won't be from patients constantly bothering you.