134 - Are You a Physician Tired of Insurance? Here’s Why Direct Primary Care (DPC) Might Be the Future (Series Kickoff)

Are you constantly frustrated with insurance red tape, packed schedules, and shrinking reimbursements as a primary care physician?

You’re not alone — and there’s a growing movement of physicians opting out of the traditional system. In this kickoff to our new Direct Primary Care (DPC) series, Coach JPMD breaks down why DPC is gaining traction and how it could be your path to less stress, more freedom, better income, and career satisfaction.

• Learn what DPC actually is and how it works (in plain terms).
  
  
• Hear why DPC may offer better work-life balance, predictable income, and lower overhead.
  
  
• Understand both the benefits and the challenges of transitioning into this model — including clinical and business readiness.

If you’re looking for a realistic, sustainable alternative to traditional primary care, this episode is your essential starting point — press play now.

Discover how medical graduates, junior doctors, and young physicians can navigate residency training programs, surgical residency, and locum tenens to increase income, enjoy independent practice, decrease stress, achieve financial freedom, and retire early, while maintaining patient satisfaction and exploring physician side gigs to tackle medical school loans.

Transcript

Coach JPMD (00:00)
So what is the future of primary care in the United States?

Welcome to another episode of the Independent Physician's Blueprint where we help physicians decrease stress and generate wealth in this crazy world we're living in. And I'm your host Coach JPMD. And we're here to talk about direct primary care, what it is, why doctors are flocking to it and why I think it is going to be the future of ⁓ medicine in some cases.

and why we really need to know more about it.

So this series is going to start with the definition of what direct primary care is. direct primary care is a membership model, healthcare benefit that is provided to members who pay a fee monthly. So just like you have a gym membership and you're allowed to go to the gym as many times as you want, direct primary care uses that same model and allows patients to seek care

in an unlimited fashion, whether it be telemedicine or through ⁓ visiting the doctor or the healthcare provider at their office. You know, this series, I thought about this series, ⁓ because obviously we're talking about this podcast, how physicians can practice independent of corporate medicine and independent of hospital systems. So one of the things that came up in an interview of a

a doctor that I'm actually looking to hire. Yes, we're looking to hire docs and anyone out there looking for jobs in the Tampa Bay area, should reach out to me because we do have lots of open positions in our current practice and some other ventures that I'm working on.

So why the series? Well, one of the things that the doctor that I was interviewing asked about was whether or not she can be part of a direct primary care practice or a group practice that doesn't take outpatient call or that doesn't take inpatient calls and ⁓ no weekends. So these are things that physicians are looking for as they are coming out of residency. So.

I felt it was a need for me to educate not only myself, but also our listeners as to what direct primary care is. So as I said, it's a membership model. Typically, patients will pay a fee ⁓ between 50 to $150 a month for services. And depending on what the provider wants to offer, it starts off with being able to

offer primary care services like blue shots, injections, lab draws, ⁓ EKGs, ⁓ visits for cold cough, congestions, some direct primary care offices also dispense medications. So if you go to the primary doctor, just like in the olden days, if your doctor is prescribing something, they could actually prescribe that medication for you in the office. And because it is a membership model, and because ⁓

the fees are paid upfront, you can understand what your income is going to be for every month and not worry about insurance billing. And so that's the other thing. Derek Primary Care doesn't accept insurance. So there is no insurance billing. There's no third party billing. It's direct to consumer health care.

Offices usually cap their membership at about 600 per provider.

And that is much different than having a population of two to 3000 members in your practice, because that's what it takes to, to generate the income that you need to cover your overhead and to pay your salary. And because that membership is capped, ⁓ you can see where the number of patients being seen is not going to be as much as the 20-30 patients that you're seeing on the fee for service insurance side. So patients usually providers see

patients, eight to 10 patients a day, patients a day. And those visits can last half an hour to an hour. Some other services that can be provided are IV infusions, body compositions, ⁓ weight loss management, hormone therapies, functional medicine labs. These are things that are available for you to do as a primary care doctor.

that you may not have the option of doing when you have insurance companies that are in the mix. The other thing that I have seen with direct primary care is that your hours are flexible. So you can determine when you wanna see patients. You can determine whether or not you wanna see patients on weekends, late nights. ⁓ You make your hours.

and then seeing patients without insurance and getting discounted drugs and discounted medications for them, you don't have to get prior authorizations from insurance companies. So those things are, think, the reasons why dark primary care is something that is going to be...

Tell me that's gonna be more common in the future. Now, I actually gave a talk recently at ⁓ one of our local hospitals to an internal medicine residency training program and came up with some calculations also. And I'm gonna share these, I'll share a link to these calculations, maybe post it on the website where I gave an example of what DPC payments. if we grew a membership to 600,

with an average membership price of $110 per month, calculating a 35 % overhead cost, the monthly overhead cost for 600 patients would be about $23,000 a month. And if you look at the income from that, minus the overhead, you're looking at an average income of about $42,900 a month.

equating to about $500,000 a year in payments. Now you may not want to or need to make that much money. And some might say that, you know, that's a lot of money for primary care. That's way above the average of average income for a primary care physician. And, you know, those are those are the numbers that I'm seeing. Those are the numbers that I've heard is possible with direct primary care.

Now, what are some of the pros and cons? So obviously, the pros is, you you have your independence, you'd be your own, but you can be your own boss at your own hours. No insurance billing kind of talked about some of those already. The overhead cost is much lower also, because if you're not seeing more than 810 patients a day, you don't necessarily need a big office space. So to generate a great income, a predictable income. And as you know, in our episode with Lee Gross,

to get the number of the episode. But I've actually interviewed him twice, one in episode 50, where he talked about his practice down in ⁓ Northport, where he's been doing this for the past 20 years. So he's a pioneer in this. So it's not something that hasn't been done before. If Christopher Habig also runs a consulting firm that helps ⁓ physicians start practices up, in episode 84.

Some of the cons, of course, as we talk about startup costs for any business, ⁓ initial capital is heavy. So you need to have the monies to start. ⁓ Marketing is really important.

you need to have a business plan and understand business. And so that's why I hope you're listening to these, the, podcasts to understand some of the business nuances and hearing from experts that, ⁓ can teach you about business so that you're not ⁓ heading into a venture like this without the knowledge, the business knowledge that you need. And, a lot of times you have no patience to start, so you're starting from zero.

And the other thing I told and I emphasize a lot on the podcast is the need for strong clinical knowledge. So if your clinical knowledge is not strong, then you know, when you're running a direct primary care practice, and you're needing to do an injection of the knee, you're not going to be consulting an orthopedic doctor. Because some of these patients, some of the patients don't can't afford to see specialists.

So you have to kind of take some of these things on your own. You have to do your own skin biopsies. So if you're not comfortable with these things, then you should definitely look to taking a course, maybe even moonlighting. I did a lot of moonlighting in the emergency rooms when I first started, and that gave me the confidence to do a lot of things that I'm doing in the primary care space. So those are the things that I think you should do as a good physician.

Now, some may say that direct primary care is like concierge medicine and that you're kind of ⁓ sub segmenting out a population of patients that can afford the monthly membership. But I challenge those that say that in ⁓ looking at insurance costs, because every year insurance costs are going up and deductibles are getting higher. reimbursement, hospital fees are higher ⁓ for x-rays and tests.

these things tend to be unaffordable. And if you can get a good primary doctor taking care of most of your things, most of the things that you need, like 80 % of what you need, then I think, again, this is going to be something that physicians should be looking into. So this is the first of a couple of episodes on direct primary care. Next up is going to be strategies for marketing.

Actually, next up is going to be startup strategies. So I'll get you some tips and things that you can do to start up a direct primary care practice. I'll have an episode on marketing and growth. We'll also have an episode on legal resources. And I'm hoping to have some legal.

experts in the direct primary care space on the podcast to kind of give us their their take on this and look at also we're gonna also get have an episode on employers and how direct primary care can help employers ⁓ decrease health care costs. So that's the episode today. We'll see you next week on another episode of the Independent Physician's Blueprint and have a great week.