Lessons I Learned from Farrago – How to Sell Your Practice: The Warm Handoff

Just under a year ago, my oldest and his wife took my granddaughter and moved across the country. Fast forward, and we’re expecting another grandchild at the end of 2026. Shortly after this exciting news, I learned that my in-law’s health had substantially declined and they were no longer safe to live at home alone, also across the country. Multiple new family needs -the best way to assist was to move closer. 

So, what’s a DPC with a thriving practice to do? Sell the practice and start a new one, of course! Over the past 1-2 years I’ve had two unsolicited offers from private equity groups to purchase my practice. I did NOT want that fate for my patients, so I started the hunt for my doppelganger, a likeminded physician I could set up for success with the sale of practice. Long story short, I found two, that both purchased part of my practice. (That’s a longer story for another day.)

When I purchased Forest Direct Primary Care from Doug Farrago, he smoothed the transition by introducing me in person to the patients while I was shadowing him for a few weeks, and to all by email/letter a month before the transition. I experienced ~4% attrition from the panel I purchased from Farrago. I only grew from there.

Farrago’s letter provided these important points:

• I’m leaving for X reason. For me, I explained the need to get closer to family.
• A brief biography about the new doc.
• The new physician is well trained, qualified and hand-picked; I have complete confidence in him (actually written but more polished: Don’t freak out; at least give this new guy a chance).
• Nothing else at the practice is going to change: name, pricing, location, staff, etc.
• Contractually, you could choose to end your membership in 30 days by giving notice. (Legal due diligence done.)
• Thank you for the privilege of trusting me with your health care for the last half decade (unwritten but clearly implied: so please trust that I picked a solid replacement).

What happened? A lot of thank you for your care and well wishes (and tears). A lot of thank you for finding a replacement physician and not just closing the practice. A lot of we trust your judgement. But what does that mean in numbers?

Of ~650 paying patients (I’m excluding charity patients):

• 4 notified me they were moving out of state (coincidental timing – they weren’t moving because I was!)
• 5 left because their employer now offered a DINO plan (I predict they’ll return)
• 4 left because they joined when they didn’t have commercial insurance, they stayed because they liked me so much, but because they aren’t sure about the new guy, and to save money, they decided to cancel (I predict they’ll return)
• 1 left because she was getting married and chose to go with coverage from her husband’s policy
• 1 left a business account and didn’t choose to stay as a member on his own (I don’t think I had even seen him once)
• 4 (of a family of 5) left due to finances (the husband stayed on to maintain a spot in the practice knowing that the rest of the family can return in the future if finances allow)

A total of 19/650 left after the announcement. That’s ~3% of the paying patients.

Lesson learned: a warm handoff works!