Earn the Nice Car

Posted on by

I’m making some memes for the blog, and these “DPC Administrator” memes are fun, because there are no DPC administrators–certainly not like there are on the inside.

While making this one, mocking the Mercedes-driving hospital administrator stereotype, I wondered if I’m not the only DPC “veteran” who gets this hard-to-describe feeling when counselling newer DPC docs. It’s a feeling like they think I’m expecting them to choose a life of poverty in order to be a “real doctor” or achieve true job satisfaction in medicine. These aren’t the right words–like I said, the feeling is difficult to describe.

I think some young doctors are impatient to start a lavish lifestyle, having worked hard for years in school/residency; they feel like they deserve [insert expensive crap here] NOW. There’s an entire separate debate to have on this issue/attitude, but for now, I’ll just say that a young physician has thus far only gotten into and through school and residency. Yes, that’s hard work, but not work that produces generous income.  This physician hasn’t really earned anything yet. This would be like if they spent 11 years and a small fortune building a machine that makes $1 widgets and they wanted a million dollars on day one, just for having built the machine. That’s not how the free market works. They need to fire up the machine, work hard cranking out and selling widgets, and soon they’ll have their money.  There’s a proper order to this.

Back to this feeling I get: It’s almost like there’s some kind of implied “voluntary socialism” in becoming a DPC doc. You will hear veteran DPC docs talk about all the strict budgeting and overhead control we do and all the stuff we sold or the sacrifices we made to be successful (eventually) in our DPC.

While it’s true that we sometimes wear our self-imposed poverty like a badge of honor, some get the wrong impression. Do most successful DPC docs live lean? Yes. Is that our ultimate goal? No!  Many are well on their way out of the lean years and have a bright financial future ahead. I guess my point is that the whole self-imposed poverty thing, in my opinion, has nothing to do with DPC, it’s just smart business.

Most successful entrepreneurs started lean. There are all these pictures out there of some of the world’s richest entrepreneurs (Jobs, Gates, Musk, etc.) setting up their startup company in the garage using milk crates as furniture, or putting their last penny on a business idea; risking everything and being practically homeless in the pursuit. In DPC we’re just free-market business people trying to build our companies–which can’t be done driving expensive cars.

Which is worth thinking about–as a doctor, you can get a job inside the system that pays enough to go buy a fancy car on day one–even if you haven’t seen a single patient yet. But at what downstream soul-selling cost? Perhaps that’s demonstrative of the entire problem inside the system. If you have no patients in DPC, you certainly will get in trouble buying an expensive car. 

So no, we don’t hire Mercedes-driving admins–we likely never will. But DPC veterans will testify that the free market will deliver the hard-working DPC start-up doc from bald tires and ramen noodles–IF they’re willing to start out with them.


Get our awesome newsletter by signing up here. It’s FREE!!! And we don’t share your email with anyone.

6

About Vance Lassey, MD

Dr. Lassey earned his medical degree from the University of Kansas School of Medicine and completed his residency at the Smoky Hill Family Medicine Program, where he served as the chief resident. He went on to practice rural inpatient, outpatient, emergency room, and obstetric care, in Holton, Kansas. He found the calling he loved to have been hijacked by middlemen. Stuck in a broken system, mired in bureaucracy, clicking boxes, coding, not seeing his family, and hearing patients complain bitterly about medical costs he had no ability to control, Direct Primary Care (DPC) became the solution for him, his family, and his patients. He is passionate about restoring the physician-patient relationship, bringing transparency and sanity to medical costs, and advises physicians around the country on how to get out of the FFS system. He serves as an Assistant Clinical Professor at the University of Kansas School of Medicine, is the recipient of numerous clinical and teaching awards, and is a founding member and the past President of the Direct Primary Care Alliance.