Wayne Lowry
Starting a direct primary care practice means leaving behind the paperwork, billing codes, and insurance middlemen that often get in the way of care. Instead, you get to build a clinic centered on patient relationships, transparency, and time. You have the chance to take back control of your schedule, provide care that reflects your values, and focus on quality rather than quantity. This model also builds trust, improves outcomes, and creates financial stability for physicians who want to serve their communities on their own terms. This guide will walk you through every stage of launching a successful DPC clinic, from business planning and legal setup to marketing, patient care, and sustainable growth.
Direct primary care (DPC) is built on a simple premise. Patients pay a flat monthly or yearly fee, and in return, they receive unlimited access to routine primary care services. That’s it. No insurance billing, no coding systems, no battles with third-party payers.
For physicians, this means fewer administrative headaches and more clinical freedom. Instead of 10-minute visits squeezed between billing demands, you can spend 30, 60, or even 90 minutes with patients if needed. That deeper connection allows you to provide care that’s both more thorough and more satisfying, for both you and the people you serve.
Patients benefit as well. Many are tired of dealing with provider directories, copays, and surprise bills. With DPC, they get clarity. They know what’s included, how to reach their doctor, and what to expect when they walk in the door.
For doctors considering a shift, starting a direct primary care practice is also a business decision. Membership fees create predictable monthly revenue. Smaller panels reduce burnout. And you get to set the tone for your practice, from service design to scheduling. You’re not building someone else’s clinic. You’re building your own.
Solid research lays the foundation for a successful DPC practice. Before leasing a space or buying equipment, take time to understand your local market. Start by analyzing the demographics in your region. Look at age ranges, income levels, employment sectors, and the number of primary care physicians already practicing nearby. Identify gaps in service or areas where patients may feel underserved or disillusioned with traditional healthcare.
This market research will shape key decisions such as what services to offer, what to charge, and how to position your clinic. For example, in areas with a high number of uninsured or underinsured individuals, affordable pricing and transparent access can be strong selling points. In areas with a strong middle-class base, wellness-focused plans and family memberships may resonate more.
Once your research is in place, build a business plan that outlines your mission, vision, service scope, pricing, patient panel goals, and revenue benchmarks. Include cost projections for the first 18 months, accounting for rent, staff salaries, legal and technology expenses, malpractice insurance, and marketing.
Most DPC clinics aim for a panel of 300 to 800 patients, which supports a lean, efficient operation while maintaining the personal feel that defines DPC. Aim to break even around the 200–300 patient mark. Many clinics hit that point in 12–18 months with consistent outreach and community engagement. A clear plan keeps your goals realistic, sustainable, and measurable.
Setting up the legal side of your DPC clinic isn’t just a checkbox. It’s what keeps your business protected and compliant from day one. The first step is choosing a business structure, typically an LLC or corporation. This offers legal protection and can provide tax advantages depending on how your income is structured.
Next, register your business with the state and obtain an Employer Identification Number (EIN) through the IRS. If you’ll operate under a name different from your legal entity (for example, “Oak Valley Family Care” instead of “John Smith, MD, PLLC”), you’ll also need a “Doing Business As” (DBA) registration.
Contracts are critical in a membership-based model. These include patient agreements that define what services are covered, what happens if membership lapses, how payments are handled, and how to terminate care. You’ll also need consent forms, HIPAA compliance documentation, records release forms, and clear policies on after-hours care and emergency procedures.
DPC law varies by state. Some require you to clearly separate services from insurance benefits, while others may have no specific DPC guidance. Consulting with an attorney who understands healthcare law ensures that your contracts and setup won’t lead to legal complications later.
Finally, designate a registered agent. This is the person or company who receives official legal and tax correspondence on your behalf. It can be you, a lawyer, or a professional service. A clean, legally compliant start helps you avoid unnecessary disruptions down the road.
The financial structure of your clinic makes or breaks your long-term success. Pricing too low may lead to burnout. Pricing too high may slow patient growth. Start by estimating your monthly operating costs. This includes your salary, rent, insurance, utilities, staff (if any), technology, marketing, medical supplies, and taxes.
Once you know your expenses, you can reverse-engineer your pricing. Let’s say you need $12,000 per month to cover costs and reach your personal income target. If your average membership fee is $80, you’ll need 150 members to break even, and around 200 to start seeing profit. For most DPCs, break-even happens between 6 and 18 months, depending on location and local demand.
Most clinics charge between $50 and $150 per month. Some offer tiered plans (basic, standard, and premium) or adjust pricing by age or family size. Pediatric rates and family bundles are common. Others focus on a flat-fee model that covers all patients equally.
What matters most is transparency. Patients need to know exactly what’s included, such as office visits, communication, labs, procedures, and what might cost extra, like imaging, advanced labs, or medications.
Building a practice also means preparing for slower periods. Your first few months may be quiet, and even established practices see seasonal dips. Having cash reserves or alternate income sources can give you room to breathe while your patient panel builds. Over time, a solid pricing model becomes the foundation for growth, stability, and freedom.
Your practice space should reflect your model: personal, approachable, and efficient. Most DPC physicians don’t need large waiting rooms or rows of exam rooms. You might start with a few hundred square feet, just enough for a private office, a single exam room, and a reception area.
Shared spaces or subleases can be a great option in the beginning. You may also consider subletting from another physician, chiropractor, or wellness provider. This keeps costs low while you grow your panel. Others start entirely mobile, offering house calls or telehealth until patient volume justifies a brick-and-mortar space.
As you shop for locations, think about patient convenience. Is parking easy? Are you near major roads or public transit? What’s the feel of the space? Sterile or welcoming? You want your space to reflect your brand, whether that’s family-focused, holistic, or professionally streamlined.
In terms of equipment, keep it simple. You’ll need a good exam table, basic diagnostic tools (otoscope, stethoscope, BP cuff, EKG), and point-of-care testing supplies if you plan to offer labs. Office tech should include a secure laptop, printer, scanner, and HIPAA-compliant document disposal system.
Finally, make sure your clinic complies with state regulations around safety, accessibility, and sanitation. You’re offering high-touch, direct care, so the space should feel clean, calm, and built for connection.
A direct primary care practice runs best with systems designed for simplicity and scalability. Your tech stack should let you focus on care, not administration. The backbone of your clinic will be your Electronic Health Record (EHR). Choose one built with DPC in mind. Platforms like Cerbo, Elation, or Atlas.md offer recurring billing, direct messaging, appointment scheduling, and charting in one dashboard.
You’ll also need a payment processor that can handle monthly membership fees, track renewals, and send automatic reminders. Integration between your EHR and payment processor is key. This cuts down on admin time and makes revenue collection seamless.
Beyond billing and records, patient communication matters. Patients should be able to text, email, or message you through a secure portal. HIPAA compliance is non-negotiable, so choose platforms that include Business Associate Agreements and end-to-end encryption.
Telemedicine expands your reach and offers patients flexibility. Whether it’s video consultations, check-ins, or follow-ups, offering care outside the clinic walls can be a value-add that strengthens loyalty.
Your website should serve as a digital front door. It needs to clearly explain how your practice works, what services are included, and how to sign up. Include online scheduling, educational blog content, pricing details, and testimonials. If you’re starting a direct primary care practice in a competitive area, SEO matters. Optimize your content for local search terms and update it regularly.
In short, your technology choices shape how efficiently your practice operates and how easily new patients find you. Think of every system as an extension of your brand and service philosophy.
One of the most common misconceptions in DPC is “if I build it, they will come.” In reality, patient acquisition requires consistent education, marketing, and community presence. You’re not just opening a clinic but essentially introducing a new healthcare model.
Start with your story. Why did you leave traditional medicine? What kind of care do you want to provide? Prospective patients connect with authenticity. Share your story on your website, social media, and during community events.
Digital marketing should include search engine optimization (SEO), Google Business Profile setup, and targeted social media campaigns. Use blog posts to answer common questions about DPC, such as “Do I still need insurance?” or “How much does it cost to join?” These educational materials build trust and help prospective members understand how the model fits their needs.
Don’t overlook in-person marketing. Sponsor a booth at local events, host free health talks, and visit nearby employers. DPC can be an affordable employee health benefit, and many small businesses are looking for ways to offer care without the complexity of traditional insurance.
Word-of-mouth will eventually become your most powerful growth tool. Satisfied patients share their experiences with family and friends. Encourage this by creating referral incentives, highlighting testimonials, and staying active in the community.
To expand visibility further, listing your clinic on the Best DPC Direct Primary Care Directory can connect you with patients actively searching for providers. It also boosts your SEO and adds another layer of professional credibility.
Daily operations in a DPC clinic are simpler than traditional practices, but they still require structure. Without the insurance billing process, you gain time, but you’ll need clear systems to stay efficient and patient-focused.
Start with scheduling. Many DPC clinics allow patients to book online, often same-day or next-day. This flexibility is a key selling point. Use automated reminders to reduce no-shows and keep your calendar organized.
Your documentation workflow should be streamlined. Use templates in your EHR to save time while maintaining high-quality charting. Focus on meaningful notes instead of coding for billing. Because you’re not submitting claims, you can document in a way that supports continuity of care, not reimbursement.
Patient communication should be easy and clear. Set boundaries for texting and emailing. Let patients know when to expect a response and what types of communication are appropriate for each channel.
If you hire staff, cross-train them to handle a variety of tasks like answering phones, scheduling, supplies, and billing follow-up. Many DPC clinics operate efficiently with just one administrative assistant. Others start completely solo and hire as they grow.
Lastly, quality improvement should be part of your routine. Track patient feedback, clinical outcomes, and panel growth. These metrics help guide improvements, refine workflows, and support patient satisfaction over time. Managing a DPC clinic isn’t about juggling paperwork. It’s about building rhythms that support great care, sustainable growth, and a rewarding practice.
Starting a direct primary care practice isn’t without its challenges. Patient education is the first big hurdle. Many patients have never heard of DPC, or they assume they’ll need insurance to see a doctor. You’ll need to explain what’s included, how it fits with high-deductible plans, and why the model benefits them long-term.
Another challenge is financial runway. You may not hit profitability for 6 to 18 months. This depends on your pricing, marketing, and local demand. Plan accordingly. Have cash reserves, consider part-time work, or offer flexible services (like telemedicine-only memberships) while your panel builds.
Scope-of-practice limitations are another consideration. Some states place restrictions on what you can include in a membership plan or which services require separate billing. Stay up to date on state law and join professional DPC networks that advocate for clarity and expansion of practice rights.
Referral networks can also be tricky. Since you’re outside the traditional system, specialists may not recognize your model or offer discounted pricing. Build relationships locally. Consider cash-pay referral lists or partnerships with labs, imaging centers, and pharmacies to help patients navigate care outside your clinic.
Lastly, make your membership contract clear. Patients should know what’s included and what’s not. Clarity up front prevents confusion and builds lasting trust. Address all these challenges early, and your DPC practice will have the foundation to grow stronger every month.
Sustainability in direct primary care isn’t just about surviving the first year. It’s about setting up a practice that can grow, evolve, and continue serving your patient base for years to come. Once your panel stabilizes and you reach profitability, it’s time to think about what comes next.
Retention should be your first focus. Keep patients engaged with consistent follow-up, proactive outreach, and a sense of community. When patients feel seen and cared for, they stay, and they tell others. This kind of word-of-mouth is invaluable in DPC, where trust is central.
You might also expand your offerings. Some physicians introduce wellness programs, in-house labs, or specialized services like minor dermatologic procedures. Others build partnerships with local providers such as nutritionists, physical therapists, or mental health counselors, to offer more comprehensive care through referral.
Professional development matters too. DPC offers a level of time flexibility that can allow you to pursue certifications or training that align with your clinical interests. This could open new service opportunities and help you stand out in a growing field.
Staying active in the DPC community is another key to long-term growth. Attend conferences, share best practices, and mentor newer physicians. Helping others doesn’t just grow the movement, it strengthens your reputation and builds lasting networks.
Finally, think about succession. Whether you plan to retire, expand, or eventually sell your practice, having clear systems and documentation will make those transitions easier. Growth isn’t just about numbers; it’s about building something lasting and meaningful.
Costs can range from $50,000 to $150,000 depending on your location, clinic size, and equipment needs. This includes startup expenses like legal setup, medical supplies, technology systems, malpractice insurance, rent, and 6–12 months of operating capital. Many doctors minimize costs by starting in small spaces, offering telemedicine, or subleasing.
Most DPC clinics reach profitability within 6 to 18 months. Factors that affect this include your pricing model, marketing efforts, and local demand. With membership fees ranging from $50 to $150 per month, practices typically become sustainable once they reach 200–300 active members.
Yes. Even if you’re not billing insurance, malpractice coverage is essential. The good news is that some insurers offer reduced rates for DPC physicians due to the lower patient volume and reduced administrative risk. Choose a policy that matches your service scope and state requirements.
DPC practices do not bill insurance for primary care services included in the membership agreement. However, you can bill separately for services that fall outside the plan, such as advanced procedures, imaging, or specialty consultations; just make sure those terms are clearly explained in your patient contracts.
Have a written policy for missed payments. Some practices allow a grace period or offer short-term payment plans. You can also include a clause for voluntary membership suspension. Transparency up front helps prevent awkward conversations or service gaps later.
Most DPC clinics offer after-hours access by phone or secure message. You might also provide video visits or same-day appointments for urgent concerns. Clearly state your availability in your membership agreement, and provide instructions for emergency care.
Starting a direct primary care practice means returning to patient-centered medicine while building a business that supports your values. You’ll face challenges (like educating your community, managing cash flow, and adapting to the unfamiliar) but you’ll also gain autonomy, flexibility, and lasting patient relationships.
Platforms like Best DPC make it easier than ever to connect with patients who are actively looking for this kind of care. Finding quality healthcare is simple when patients can search and connect directly with trusted Direct Primary Care providers. For physicians ready to grow their reach, joining a network like Best DPC helps expand visibility and attract people already committed to this model.
From business planning to long-term growth, every step is an opportunity to shape the practice you want. Whether you’re just beginning to sketch out your ideas or already preparing to launch, keep this in mind: people are looking for better care, and DPC gives you the chance to provide it on your terms.
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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