I want to give the secret to expanding Direct Primary Care by ten to fifteen times. Please don’t tell anyone. Ok, here goes:

YOU CAN’T DO IT!

Oh, you’ll try (and many are trying right now).

First, you’ll salivate at the success of independent DPC docs. Then you’ll brainstorm and think, “I can massively scale this thing!” You know that investors want 10x their money and they want it quickly. To do that you realize you have to use more non-doctors and pay them much less. Then you realize you have to dilute this more by using AI. You’ll call it some high-tech term and use pretty software that really does nothing new. That will work for a while and get you some press (see Forward). You may even impress some patients but primary care is still primary care. Patients want to see their doctors and not a team of anyone else you are replacing them with because you don’t want to pay for doctors. So, you try telemedicine with nondoctors. Hooray!! That’ll do it. Who needs to pay for an office space when you can do it all via Zoom? But you can’t. The funny thing about telemedicine is that it is an adjunct to a real DPC practice, not a replacement (see Eden Health). Now you’re in a pickle. It seems that the only successful scaling of REAL Direct Primary Care is clinics with doctors who have some skin in the game. This is not 10x. Not even close. But it is profitable. Unfortunately, that’s not good enough for the investors you conned into supporting your plan. Your dreams are shattered. Back to the drawing board. Why?

Because you can’t 10x Direct Primary Care!

Below is something I found online. This is for you docs who want to work for these big corporations. PE = private equity.

The above is as predictable as the sun rising in the east and Vance Lassey hitting his head on every top door beam.

Start your own practice or caveat emptor (buyer beware).

(Editor’s note: this does not mean we won’t take advertising money from them. Money is money and we got to put food on the table somehow).