You cannot save some people. Some physicians will never jump into direct primary or specialty care. I am a big believer in paying it forward by constantly spreading the word and educating other doctors about Direct Primary Care. That being said, not all are ready to do it, and some really shouldn’t try. And that is okay. No judgement.
When I did my keynote talk about DPC practices that fail at the DPC Summit a couple of years ago, I tried to show which characteristics lead to people closing their offices. One was not having their heart fully into making it work. You cannot dabble in DPC. It’s best you go back into the crevice of the system.
Dr. Farrago is a retired family physician based in Forest, Virginia. Since 2021, he has run DPCnews.com, a leading resource for the Direct Primary Care (DPC) movement.
He is the author of three best-selling books on Direct Primary Care:
The Official Guide to Starting Your Own Direct Primary Care Practice
The Direct Primary Care Doctor’s Daily Motivational Journal
Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity)
In 2016, Dr. Farrago conceived the idea for the Direct Primary Care Alliance and co-founded the organization alongside other pioneering DPC physicians. He is widely recognized as a leading expert in the DPC model and frequently lectures to medical students, residents, and practicing physicians on how to successfully start and run their own DPC practices.Dr. Farrago sold his Direct Primary Care practice in October 2020 but continues to receive care there as a patient.
One thought on “This is going to sound bad, but….”
The problem with DPC is one will likely end up with nut-case psycho-patients that think they have every disease under the sun but don’t have anything. Cheaper for them to pay a monthly fee than have insurance. A program director told me to let them come in every 2 weeks and pat them on the hand and send them on their way. I hated spending an hour with a patient who I knew had nothing and I never made a mistake here with nut-case patients. I had some cases where I thought deep down they had a condition and weren’t nut cases. Referred them to some major centers, sometimes many times, until one would come up with a “non-psychogenic” but physical problem that was treatable sometimes not treatable. Man these docs I referred to would send me long consultant letters about the patients and the treatment needed as they liked seeing something that was right in the core of their specialty. Somewhere in there, they complemented me on my persistence as most primary care docs would dismiss them as a psychogenic problem. You better believe those particular patients stayed with me to my retirement as I would admit up front, I didn’t know what was going on and would find someone who could help us. Many times under coaching from the specialists, I could carry on the care myself. If I needed help with a situation on a patient the specialist’s who helped me with before would pickup on my call right then and there when I was getting puzzled on how a condition was evolving. Would give me advice and sometimes would set up a new appointment with the patient right then and there to look into it further.
Yeah with DPC, a doc can fire a patient after going through the lengthy process of doing it and I fired a few myself under the old practice regiment. Especially when their demands became intolerable and I couldn’t stand it anymore. It was rare but I did do it. A little old lady who needed to talk to someone. My staff learned it would take extra time and allowed for it. I learned a lot about history with people who lived through it. Oh, I dictated my notes so future doctors could read them and see where I was going. Kurt
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The problem with DPC is one will likely end up with nut-case psycho-patients that think they have every disease under the sun but don’t have anything. Cheaper for them to pay a monthly fee than have insurance. A program director told me to let them come in every 2 weeks and pat them on the hand and send them on their way. I hated spending an hour with a patient who I knew had nothing and I never made a mistake here with nut-case patients. I had some cases where I thought deep down they had a condition and weren’t nut cases. Referred them to some major centers, sometimes many times, until one would come up with a “non-psychogenic” but physical problem that was treatable sometimes not treatable. Man these docs I referred to would send me long consultant letters about the patients and the treatment needed as they liked seeing something that was right in the core of their specialty. Somewhere in there, they complemented me on my persistence as most primary care docs would dismiss them as a psychogenic problem. You better believe those particular patients stayed with me to my retirement as I would admit up front, I didn’t know what was going on and would find someone who could help us. Many times under coaching from the specialists, I could carry on the care myself. If I needed help with a situation on a patient the specialist’s who helped me with before would pickup on my call right then and there when I was getting puzzled on how a condition was evolving. Would give me advice and sometimes would set up a new appointment with the patient right then and there to look into it further.
Yeah with DPC, a doc can fire a patient after going through the lengthy process of doing it and I fired a few myself under the old practice regiment. Especially when their demands became intolerable and I couldn’t stand it anymore. It was rare but I did do it. A little old lady who needed to talk to someone. My staff learned it would take extra time and allowed for it. I learned a lot about history with people who lived through it. Oh, I dictated my notes so future doctors could read them and see where I was going. Kurt