Is DPC Scalable?

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The question itself is grotesque. What is scalability other than corporate exploitation? What’s beautiful about DPC is removal of the corporate element, which allows the doctor-patient relationship to bloom.

Let’s imagine that a giant online retailer (we’ll call it Pharmazon) added a dirt-cheap DPC option with access to rock bottom prices on labs and medications. Of course, the medical advice would be 90% AI and 10% NP, and there would be massive over-prescribing and over-testing, because the “providers” would be incentivized to do so. They would also be incentivized to recommend various Pharmazon products. In fact, the sellers would pay a premium for their products to be recommended as “medical advice”. Is this version of DPC scalable? YES! Is it profitable? HELL YES! Is it good medical care? WHO CARES! IT’S SCALABLE AND PROFITABLE! 

Obviously, this is not good medicine. It’s completely unethical and unsafe for patients. Although patients may be attracted by the ease of these telemedicine platforms to order up any medication they desire without the hassle of an appropriate medical evaluation or discussion of the risks involved, I would recommend that patients seek out independent physicians whenever possible. What’s good for patients (and for physicians) is the opposite of scalability: a wide variety of independently-owned DPC practices where patients can seek out a physician who meets their unique needs and develop a trusting relationship with that physician over time.

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About Emily O'Rourke, MD

Dr. Emily O'Rourke started Fountain Direct Primary Care, the very first DPC practice in Hampton Roads, Virginia, in October 2018. She enjoys working with her patients on individualized treatment plans, including lifestyle modification, in order to transform their physical and mental health and help them achieve their goals and live more fulfilling lives. She also serves as an FAA Aviation Medical Examiner and performs Veteran Disability Examinations. Dr. O'Rourke was born and raised in the state of Nebraska, and she graduated with distinction from the University of Nebraska - Lincoln. She completed her medical education at the University of Nebraska Medical Center in 2010. She served as Chief Resident during her final year of the Eastern Virginia Medical School Portsmouth Family Medicine residency program. Dr. O'Rourke is Board Certified in Family Medicine through both the American Board of Family Medicine and the National Board of Physicians and Surgeons. Dr. O'Rourke lives in Chesapeake, Virginia with her husband, Jimmy, and their two sons, Logan and Jackson. She practices yoga regularly and enjoys creative pursuits, including crocheting and playing the cello.