DPC Myth #9: You Need a Lot of Staff In Your Office
I have had a DPC micropractice for the past seven years, and I really appreciate the simplicity and flexibility of practicing medicine without staff. A micropractice really puts the “direct” into Direct Primary Care because I communicate directly with my patients rather than hiring staff or utilizing AI software for patient communication and scheduling. Because I give my patients my full attention during appointments, this means that my other patients will sometimes have to wait a couple of hours to speak with me, but most agree that it’s worth the wait, since they can trust that they are getting advice directly from a physician.
In the system, the primary purpose of staff is to keep the schedule packed with as many patients as possible because the practice makes more money by seeing more patients. Unnecessary visits are a great source of income, which includes visits to discuss normal lab results, visits for mild cold symptoms, visits to follow up on a new medication, or visits for a quick question. In DPC, the purpose is to provide excellent care, not to pack the schedule. Much of the time, excellent care can be delivered remotely, and patients appreciate the convenience of getting medical advice from their own physician without being forced to take time off work or to leave the comfort of their own home. Sometimes excellent care requires an in person visit, and providing remote care creates plenty of availability in the schedule to examine patients urgently whenever it’s needed or desired. By triaging my own patients, I can ensure that they all get the appropriate treatment.
When I worked in the system, I often saw patients for 11 hours straight without any breaks, so it definitely was not possible to take calls from patients during that time or deliver any form of remote patient care. Any patients who called would automatically be put on the schedule. The other purpose of staff in the system is to complete as many clinical tasks as possible to leave the physicians free to see patients. These tasks include sending prescription refills, completing prior authorizations, sending out referrals and orders for testing, and receiving test results and specialist consultation notes. In my DPC practice, I enjoy completing these clinical tasks because each one is a reminder to ensure that the patient has completed the appropriate testing and is also up-to-date on preventative screening. I’m also prompted to check in with patients on their treatment plan to make sure it’s working well for them.
I think it’s important to design your practice around your strengths, weaknesses, and preferences. As an introvert, I enjoy scheduling in some alone time each day to complete clinical tasks. I know that my management skills are lacking and that I tend toward micromanagement. Since staff communicate with female physicians over twice as much as with male physicians, it’s unlikely that hiring staff would decrease my own workload. In fact, hiring staff would create complexity for my business and far more work for myself in terms of hiring, firing, training, compliance, and management, which I have neither the skill nor the desire to do.
This DPC Mythbuster Series aims to debunk the most common fears, misconceptions, and half-truths that deter doctors from embracing Direct Primary Care. These opinions are from each individual blogger. You may or may not agree with them, but either way, leave a comment with your thoughts.
