Wayne Lowry
For many physicians, the daily grind of insurance codes, 10-minute visits, and rushed care leaves them questioning why they went into medicine in the first place. That’s where direct primary care (DPC) offers something different. It’s not a shortcut. It’s a return to real doctoring.
If you’ve been wondering how to start a direct primary care practice, you’re not alone. More doctors are stepping away from large systems and choosing patient-first models that allow time, connection, and control. The DPC approach removes insurance from the equation so you can spend more time with people and less with paperwork. You can also browse established practices on Best DPC, a national directory that showcases how physicians are making this transition across the country.
Building a DPC practice means taking charge of your location, pricing, and schedule. Most panels max out at 600 to 800 patients, which means fewer appointments but more time with each person. That’s not just good for patients. It’s good for your career and your well-being.
If you’re ready to practice medicine on your terms, learning how to start a direct primary care practice could be the next step. This model, essentially, is a real way forward for doctors who want to care for people, not just process visits.
Direct Primary Care changes how healthcare works by removing insurance from the equation and building direct relationships between doctors and patients. It offers a practical, lasting model that supports both physicians and the communities they care for.
Physicians experience profound professional advantages through the DPC model. For instance, they maintain smaller patient panels averaging 400-600 patients compared to 2,000-3,000 in traditional practices. This reduction, in turn, allows for 30-60 minute appointments instead of rushed 7-minute visits. Consequently, doctors achieve better work-life balance while earning predictable monthly revenue through membership fees.
Similarly, patients gain unprecedented healthcare access through Direct Primary Care practices. Members, for example, enjoy same-day appointments, unlimited visits, and direct communication with their primary care physician via phone, email, or text. Moreover, the subscription model provides cost transparency, with monthly fees typically ranging from $50-$150, covering comprehensive primary care without copays or deductibles.
Among the top patient benefits include:
The DPC model takes a different approach to healthcare by removing the layers of insurance-based billing. While traditional practices depend on fee-for-service systems that tie up nearly half of a doctor’s time with paperwork, DPC uses straightforward membership plans to cut through the red tape.
| Aspect | Traditional Practice | Direct Primary Care |
|---|---|---|
| Patient Panel Size | 2,000-3,000 | 400-600 |
| Appointment Length | 7-15 minutes | 30-60 minutes |
| Revenue Model | Insurance billing | Monthly memberships |
| Administrative Staff | 4-5 per physician | 0-1 per physician |
| Patient Access | Limited, scheduled | Direct access via multiple channels |
DPC practices prioritize Holistic approach and Patient-centered care over volume-based metrics. Healthcare providers focus on Chronic disease management and Annual check-ups without insurance constraints. The model incorporates Care coordination with specialists while maintaining the primary relationship. Members often combine DPC memberships with Health savings account contributions and high-deductible insurance for catastrophic coverage, creating Affordable healthcare solutions that emphasize prevention and wellness.
Starting a DPC practice requires thorough planning that aligns with the patient-centered care philosophy. The planning phase establishes the foundation for delivering personalized medicine while building sustainable operations.
A clear vision guides every decision in establishing a Direct Primary Care practice. Physicians create mission statements that reflect their commitment to the doctor-patient relationship and comprehensive services. Successful DPC practices articulate specific goals for patient care delivery and community impact.
The vision encompasses practice values including preventive care priorities and holistic approach to wellness. Many practitioners emphasize accessibility and cost transparency as core principles. They outline how their DPC model differs from traditional insurance-based practices.
Mission development involves identifying target patient populations and their healthcare needs. Physicians consider demographics, chronic disease management requirements, and preventive care opportunities in their communities. The mission statement becomes a reference point for service design and operational decisions.
Market research reveals opportunities for DPC practices in specific communities. Physicians analyze local healthcare provider density, insurance coverage gaps, and patient demand for direct access to primary care. Research includes reviewing competitor pricing structures and service offerings.
| Market Analysis Factors | Key Considerations |
|---|---|
| Population demographics | Age distribution, income levels, health conditions |
| Competitor landscape | Existing DPC practices, traditional primary care availability |
| Pricing benchmarks | Local membership fees, service inclusions |
| Community health needs | Chronic conditions, preventive care gaps |
Feasibility studies examine startup costs against projected patient enrollment. Practitioners evaluate office space options, equipment needs, and technology requirements. Financial projections consider membership growth rates and operational expenses during the first 18 months.
Patient surveys provide insights into desired services and pricing tolerance. Community feedback shapes service design and membership structures. Healthcare providers assess employer interest in corporate memberships for employee health benefits.
Comprehensive business plans outline financial projections, operational strategies, and growth targets. DPC physicians develop budgets covering startup expenses ranging from $30,000 to $70,000. Plans detail monthly operational costs including rent, staff salaries, and technology subscriptions.
Revenue projections calculate membership fees multiplied by expected patient panel size. Most DPC practices achieve profitability with 300-600 patients. Business plans include break-even analysis and cash flow management strategies.
Service descriptions specify included benefits:
Marketing strategies outline patient acquisition approaches. Plans incorporate digital presence development, community outreach, and employer partnerships. Operational workflows detail appointment scheduling, patient communication, and membership management systems.
Legal structure selection impacts taxation and liability protection. Many physicians choose LLC or PLLC formations based on state regulations. Business plans include compliance requirements and professional insurance coverage details.
Starting a Direct Primary Care (DPC) practice involves understanding specific legal requirements that differ from traditional practices. It’s important to ensure compliance to protect both the practice and its patients.
Each state has its own regulations for DPC practices. Physicians need to familiarize themselves with their state’s DPC laws, as many states have specific legislation regarding this model. These laws often clarify that DPC agreements are not insurance products.
Key compliance areas include:
Consulting with healthcare attorneys can help ensure compliance with state regulations.
Liability insurance is crucial for DPC practices, providing protection against malpractice claims. Physicians should consider coverage amounts, policy types, and additional protections when selecting insurance.
Choosing the right business structure is essential for liability protection and tax obligations. Common options include PLLC, LLC, S Corporation, and Sole Proprietorship. Each has different implications for liability, taxes, and complexity.
Registration steps typically involve applying for a federal EIN, state business registration, and obtaining necessary licenses. It’s advisable to seek professional guidance to navigate this process effectively.
The choice of business structure can influence future growth and operational flexibility, so it’s important to consider long-term goals when establishing a DPC practice.
Establishing a strong financial foundation is crucial for the long-term success of a Direct Primary Care (DPC) practice. A well-rounded financial plan balances initial investments with sustainable revenue models while ensuring affordability for patients.
The initial investment for a DPC practice can vary based on location and scope. Essential costs typically include office space, medical equipment, technology, and marketing efforts.
Key budget categories to consider include:
Physicians can minimize costs by adopting phased approaches, such as starting with house calls or leasing equipment instead of purchasing it outright. Utilizing digital marketing can also help connect practices with patients in a cost-effective manner.
Membership pricing is a key factor in practice sustainability and patient accessibility. DPC practices often establish fees that reflect the services offered, community demographics, local competition, and operating costs.
Transparent pricing is essential for building trust with patients. Successful practices clearly communicate the services included in membership, such as check-ups, chronic disease management, and direct access to physicians. Additional services can enhance value without significantly increasing membership costs.
Financial sustainability in DPC relies on predictable membership revenue and strategic growth planning. Practices typically aim for a certain number of active members to achieve profitability within a reasonable timeframe.
Effective revenue modeling involves making realistic assumptions about growth rates, retention rates, and collection efficiency. Cash flow management is critical, as monthly membership fees provide steady income, unlike traditional fee-for-service models. Maintaining an operating reserve can help protect against unexpected costs or slower growth.
Overall, the DPC subscription model offers predictable revenue streams that benefit both physicians and patients. By eliminating the complexities of insurance billing, practices can reduce administrative costs and enhance patient services, fostering a sustainable healthcare delivery model focused on the doctor-patient relationship.
Creating the right infrastructure forms the foundation of a successful Direct Primary Care practice. The physical environment and technological systems directly impact patient experience and operational efficiency.
Location selection significantly influences practice success and patient accessibility. DPC practices thrive in areas with convenient parking and easy access to major roads. Consider demographics when evaluating potential sites—neighborhoods with families and working professionals often appreciate the Direct Primary Care model’s flexibility.
Square footage requirements typically range from 1,200 to 2,500 square feet for a solo practitioner. The space accommodates 2-3 exam rooms, a waiting area, office space, and storage. Some physicians start with shared medical spaces or sublease from existing practices to minimize initial costs.
Zoning regulations vary by municipality. Verify the property allows medical practice operations before signing any lease agreements. Consider proximity to complementary healthcare services like laboratories and imaging centers, as these partnerships enhance comprehensive services for patients.
Equipping a DPC practice requires balancing functionality with budget constraints. Essential medical equipment includes:
| Equipment Category | Items Needed | Estimated Cost Range |
|---|---|---|
| Examination Tools | Stethoscopes, otoscopes, blood pressure monitors | $2,000 – $4,000 |
| Diagnostic Equipment | EKG machine, pulse oximeter, glucometer | $3,000 – $8,000 |
| Office Furniture | Exam tables, chairs, desks, filing cabinets | $5,000 – $10,000 |
| Medical Supplies | Bandages, syringes, medications | $1,000 – $3,000/month |
Technology infrastructure proves equally important. Secure internet connectivity supports telemedicine capabilities and Electronic Health Records systems. Phone systems with multiple lines ensure direct access—a cornerstone of the doctor-patient relationship in DPC.
Budget approximately $15,000 to $25,000 for initial equipment purchases. Leasing options exist for expensive items like EKG machines, helping practices manage cash flow during startup phases.
Electronic Health Records (EHR) systems streamline operations while maintaining the personalized medicine approach DPC champions. DPC-specific features differentiate these systems from traditional practice management software.
Key EHR considerations include:
Popular EHR options for DPC practices include Hint Health, Atlas MD, and Spruce Health. Monthly costs range from $200 to $500 depending on patient volume and features selected. These platforms emphasize the subscription model unique to DPC while maintaining compliance with healthcare regulations.
Data migration from previous systems requires careful planning. Allocate 2-3 months for EHR implementation and staff training. The investment in proper technology infrastructure enhances care coordination and supports the holistic approach that distinguishes Direct Primary Care from traditional models.
Practices benefit from choosing cloud-based systems that offer automatic updates and remote access capabilities. This flexibility aligns with DPC’s patient-centered care philosophy, allowing physicians to review records and respond to patient needs outside traditional office hours when necessary.
For physicians exploring DPC opportunities, exploring infrastructure requirements helps estimate startup investments accurately. The DPC community continues evolving best practices for efficient practice setup. Additional resources and insights about DPC guide new practitioners through infrastructure decisions. Physicians ready to embrace this model can join the movement toward accessible, relationship-based primary care.
Growing a thriving patient panel forms the cornerstone of any successful Direct Primary Care practice. Building meaningful relationships with members while maintaining sustainable growth requires strategic marketing, efficient onboarding processes, and clear contractual frameworks.
Effective marketing starts with exploring the unique value proposition of the DPC model. Physicians leverage multiple channels to communicate how Direct Primary Care transforms the doctor-patient relationship through enhanced access and personalized medicine.
Digital presence drives patient acquisition in today’s healthcare landscape. Creating a professional website that clearly explains membership benefits, cost transparency, and comprehensive services helps potential patients understand the DPC model. Physicians optimize their online visibility by registering with DPC directories and maintaining active Google My Business profiles.
Community engagement amplifies marketing efforts through:
Word-of-mouth marketing proves particularly powerful in DPC practices. Satisfied patients become advocates when they experience same-day appointments, unhurried visits, and direct access to their primary care physician. Marketing materials emphasize tangible benefits like unlimited visits, transparent pricing, and the elimination of insurance bureaucracy.
Streamlined onboarding transforms interested individuals into engaged members who fully utilize their DPC benefits. The process begins with an initial consultation where physicians explain the subscription model, service scope, and how patients access care.
| Onboarding Stage | Key Activities | Timeline |
|---|---|---|
| Initial Contact | Practice tour, membership explanation | Day 1 |
| Enrollment | Agreement signing, payment setup | Days 2-3 |
| Health Assessment | Comprehensive physical, medical history | Week 1 |
| Care Planning | Personalized health goals, preventive care schedule | Week 2 |
| Follow-up | Check-in call, portal training | Week 4 |
Technology enhances the onboarding experience through patient portals that facilitate direct communication and appointment scheduling. Staff members guide new patients through accessing telemedicine features, exploring their health savings account integration options, and maximizing their membership benefits.
Successful onboarding addresses common concerns about specialist referrals and care coordination. Physicians explain how the DPC model maintains relationships with specialists while helping patients navigate the broader healthcare system cost-effectively.
Clear service agreements establish mutual expectations between physicians and patients, protecting both parties while fostering trust. Well-crafted contracts address essential elements without creating barriers to the doctor-patient relationship.
Key contract components include:
Contracts emphasize the holistic approach of DPC while clarifying boundaries. For instance, agreements typically specify that membership covers comprehensive primary care but excludes specialist services, hospitalizations, or major procedures. This transparency prevents misunderstandings and reinforces the value of pairing DPC membership with high-deductible insurance plans.
Legal counsel familiar with state-specific DPC regulations helps physicians craft agreements that comply with local requirements while maintaining the flexibility essential to patient-centered care. Regular contract reviews ensure agreements evolve with practice growth and changing healthcare regulations.
The DPC community provides valuable resources for developing effective member agreements that balance legal protection with the relationship-based care that defines Direct Primary Care.
Efficient daily operations form the backbone of a successful Direct Primary Care practice. Streamlined systems ensure physicians can focus on patient care while maintaining the administrative excellence that distinguishes DPC from traditional models.
Direct Primary Care practices thrive on flexibility and patient accessibility. Implementing user-friendly scheduling systems allows members to book same-day appointments through online portals or mobile apps.
Successful DPC practices maintain open schedules with 30-60 minute appointment slots. This extended time enables comprehensive care coordination and strengthens the doctor-patient relationship. Many practices reserve morning hours for acute visits and afternoons for annual check-ups and chronic disease management.
Buffer times between appointments accommodate walk-ins and urgent needs. Some practices implement color-coded scheduling systems to distinguish between preventive care visits, follow-ups, and acute care needs. This visual organization helps staff prioritize patient flow while maintaining the personalized medicine approach that defines DPC.
The subscription model simplifies billing compared to insurance-based practices. Automated monthly membership collection through platforms like Stripe or Square eliminates administrative burden. Most DPC practices process payments on the first of each month, creating predictable cash flow.
Transparent pricing structures typically include:
| Service Type | Payment Method | Frequency |
|---|---|---|
| Membership Fees | Auto-debit | Monthly |
| Lab Work | Direct Payment | As needed |
| Medications | Point of Sale | Per visit |
| Specialist Referrals | HSA/Self-pay | As needed |
Cost transparency remains paramount. Practices display all fees clearly on their websites and service agreements. Many integrate with Health Savings Account processors to streamline self-pay options. This approach eliminates surprise billing and reinforces the trust inherent in the DPC model.
Building the right team determines practice success. DPC practices typically operate with lean staffing—often one medical assistant per physician. This structure maintains cost-effectiveness while delivering exceptional patient-centered care.
Key positions include:
Training emphasizes the holistic approach unique to DPC. Staff learn to prioritize relationship-building over volume. New team members shadow experienced staff for 2-3 weeks to understand the practice’s culture and workflows. Regular training sessions cover topics like motivational interviewing, chronic disease management protocols, and technology updates.
Practices investing in comprehensive staff development report higher member satisfaction and retention. Cross-training ensures continuity when team members are absent. Many successful DPC practices create standard operating procedures for common tasks, ensuring consistent service delivery regardless of who assists the patient.
The healthcare provider-staff relationship mirrors the doctor-patient relationship in DPC—built on mutual respect and shared commitment to accessible, relationship-based primary care. This alignment creates positive work environments that attract and retain quality team members, further enhancing the practice’s ability to deliver on its promise of personalized, accessible healthcare through the Direct Primary Care model.
For physicians ready to transform their practice operations, resources like Best DPC offer valuable insights into successful practice management. The platform helps connect healthcare providers with proven strategies for building thriving DPC practices. Those exploring the DPC model can search for examples of well-run practices or learn more about the operational excellence that defines successful Direct Primary Care. Additional operational insights and best practices are regularly shared on the Best DPC blog, while physicians ready to embrace this model can join the community of innovative healthcare providers revolutionizing primary care delivery.
Successfully launching a Direct Primary Care practice marks just the beginning of the journey. Growth strategies focus on enhancing service offerings, developing strategic partnerships, and tracking performance metrics that demonstrate the value of patient-centered care.
DPC practices expand their service scope strategically to meet evolving patient needs while maintaining the core philosophy of accessible, relationship-based care. Physicians often integrate preventive care programs, chronic disease management protocols, and wellness initiatives that align with their patient demographics.
Popular service additions include:
These expansions enhance the comprehensive services available under the subscription model, increasing member value without compromising the doctor-patient relationship. Practices evaluate each addition based on patient demand, equipment costs, and alignment with their holistic approach to healthcare.
Service expansion decisions consider staff expertise, training requirements, and regulatory compliance. Many practices phase in new offerings gradually, ensuring quality maintenance while building capacity. This measured approach preserves the personalized medicine experience that distinguishes DPC from traditional models.
Strong referral networks amplify a DPC practice’s ability to provide coordinated care beyond primary services. Establishing relationships with specialists, diagnostic centers, and ancillary providers creates a comprehensive healthcare ecosystem for members.
Effective network development strategies include:
These partnerships benefit all parties – specialists receive appropriate referrals, patients access affordable specialty care, and DPC physicians maintain continuity in their patients’ healthcare journey. Direct communication between providers enhances care coordination, reducing duplicated tests and improving outcomes.
Many DPC practices leverage their membership model to negotiate volume discounts with imaging centers, laboratories, and specialty groups. These arrangements provide cost transparency for patients while strengthening the practice’s value proposition.
Data-driven evaluation guides sustainable growth in DPC practices. Key performance indicators extend beyond traditional financial metrics to encompass patient satisfaction, health outcomes, and operational efficiency.
| Metric Category | Key Indicators | Target Benchmarks |
|---|---|---|
| Patient Growth | Monthly enrollment rate | 10-20 new members |
| Retention | Annual renewal rate | >90% |
| Clinical Outcomes | A1C improvement, BP control | 15-20% improvement |
| Patient Satisfaction | Net Promoter Score | >70 |
| Financial Health | Monthly recurring revenue | $50,000-100,000 |
| Operational Efficiency | Patient panel per physician | 400-600 members |
Regular metric evaluation identifies growth opportunities and operational improvements. Practices track patient access metrics like same-day appointment availability and response times for patient communications. Clinical outcome measurements demonstrate the effectiveness of the DPC model in managing chronic conditions and preventing acute episodes.
Financial metrics focus on sustainable growth patterns rather than rapid expansion. Successful practices maintain balanced growth rates that preserve quality while building toward profitability. Member acquisition costs, lifetime value calculations, and churn rates inform marketing strategies and service refinements.
Patient feedback systems capture qualitative data about the care experience. Regular surveys, suggestion boxes, and informal conversations provide insights that quantitative metrics might miss. This comprehensive approach to measurement ensures practices grow while maintaining their commitment to accessible, patient-centered care.
Starting a Direct Primary Care practice is essentially about reclaiming the essence of medicine and building meaningful patient relationships. The journey from initial planning to establishing a thriving practice requires dedication and strategic thinking but offers physicians the freedom to practice medicine on their own terms.
Success in DPC comes from combining sound business practices with an unwavering commitment to patient care. As more physicians discover the professional fulfillment and financial sustainability this model provides, they’re creating a healthcare shift—one relationship at a time.
The future of primary care lies in these direct connections between doctors and patients. For physicians ready to break free from insurance constraints and administrative burdens, DPC offers a proven path forward. To increase visibility and connect with patients, new clinics can get listed on Best DPC.
With careful planning and genuine dedication to patient wellness, any physician can build a practice that transforms both their professional life and their patients’ health outcomes.
Direct Primary Care is a healthcare model where patients pay a monthly membership fee directly to their physician, eliminating insurance intermediaries. This allows doctors to maintain smaller patient panels, offer longer appointments, and provide same-day access. Patients enjoy unlimited visits, direct communication with their doctor, and transparent pricing without copays or deductibles.
Starting a DPC practice typically requires $30,000 to $70,000 in initial investment. This covers office setup, medical equipment, technology systems, legal compliance, marketing, and operating reserves. Most practices achieve profitability with 300-600 active members and break even within 12-18 months of operation.
DPC membership fees generally range from $50 to $100 per adult patient per month. Pricing depends on factors including service scope, local demographics, competition, and operating costs. Many practices offer family discounts and reduced rates for children to make care more accessible.
DPC eliminates insurance billing, allowing physicians to focus on patient care rather than paperwork. Doctors maintain smaller patient panels (600-800 vs. 2,000-3,000), offer 30-60 minute appointments instead of 15 minutes, and provide same-day access. The subscription model creates predictable revenue while reducing administrative burdens by up to 40%.
DPC regulations vary by state, so research your specific state’s laws regarding membership agreements, fee structures, and service scope definitions. While you don’t need special licenses beyond your medical license, ensure compliance with state DPC regulations and maintain appropriate professional liability insurance tailored to the DPC model.
Yes, many DPC members pair their membership with high-deductible health plans or health savings accounts for comprehensive coverage. While DPC covers primary care services, patients typically maintain insurance for specialists, hospitalizations, and emergencies. This combination often results in lower overall healthcare costs with better access to care.
Essential technology includes a cloud-based Electronic Health Records (EHR) system designed for DPC practices, patient communication platforms, online scheduling tools, and membership management software. Choose systems that support telemedicine, automate billing, and enhance patient engagement while maintaining HIPAA compliance.
Successful patient recruitment strategies include creating a professional website, engaging in community outreach, hosting educational events, and leveraging social media. Word-of-mouth referrals from satisfied patients are particularly effective. Emphasize the benefits of personalized care, extended appointments, and direct physician access in your marketing efforts.
ABOUT AUTHOR
Wayne Lowry
Wayne Lowry, Founder of BestDPC, is a passionate advocate for Direct Primary Care (DPC) and its mission to deliver personalized, accessible healthcare. He believes that DPC providers should serve as the trusted first point of contact for all medical needs, ensuring patients never feel isolated or uncertain about their health decisions. Through his work, he champions a patient-first approach to healthcare, building a system that prioritizes guidance, support, and trust.
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