After 4 years of involvement with the DPC community, I am finally opening my own DPC. Doug Farrago recently posted how he journaled at the beginning of his DPC journey. He encouraged me to do the same as I’m starting. We both thought it would be interesting for me to post my experience on here as I go through it. For the RaMS (resident and medical student) audience, this will give a more detailed look into what it’s like starting a DPC. For the other newbies, this will hopefully be relatable, and for the veterans, maybe it will give you some nostalgia. Whichever cohort you are in, I’d love advice, feedback, or questions and you can feel free to reach me at [email protected] This series is by no means meant to be instructional, it’s simply me sharing my experience as I learn along the way.
Even though I’ve been learning about and promoting DPC since 2017, I only decided to open my own practice August 2020. I picked my location just outside Richmond, VA because that’s where I went to med school and had connections, I was familiar with the area and community, and the Richmond suburbs have been booming in the last few years. Due to a great stroke of luck, one of my co-residents wanted to join my DPC and so I have her on this year as an independent contractor. This was my starting point. I really started working on everything around October. For the sake of brevity, this post will hit some of the highlights from the last several months and then future posts will delve into my weekly or biweekly details.
Name, Logo, and website oh my: Common approaches to name are doctor name, location name, or a meaningful symbol. I decided to be too clever for my own good and chose EuDoc for my name which comes from the Greek prefix eu for good or well. Once I had my name I had to figure out a logo. Some options I explored were 99designs and Fiverr as well as a local graphic design firm. Ultimately, I ended up using my rudimentary digital art skills to make my own logo. This ended up taking hours and hours and I went through at least ten different versions. If I did all over again, I probably would have gone with the graphic design firm for the connections and to have a professionally drawn image. Though I did get much better at Adobe Illustrator from this experience. Once I had a logo, I built my own website (www.eudoc.me). I chose Squarespace because it was easy to use and people I knew used it so I could ask questions if I had issues. Other platforms people use are Wix and WordPress. The website also took a very significant amount of time in order to finalize design, content, and navigation. There are plenty of services out there if dumping hours into designing a website does not sound appealing.
LLC, the first key: The process in Virginia was fairly easy, the only complication was address. Some people use their home address, but the LLC filing is public information so I didn’t want to do that. I ended up using a virtual address through UPS for the filing. Virtual addresses have varying degrees of usefulness. For me, it was only helpful to get the LLC. Everything else required a real physical address. That early on I didn’t have a wouldn’t have a physical address but I needed the LLC because it unlocks the EIN which is needed for a business bank account which is needed for literally everything else.
Location, location, location: Persistence and luck were the two pillars in getting my lease. All I had in my head was a general idea of what I wanted in terms of space and design. The rest was just going to a bunch of places and exploring. I got lucky with a good realtor who was responsive and taught me a lot along the way. Turns out you can just call the people’s name on the For Lease billboards and they end up being your realtor. Mine got paid from the final lease amount. Seems like a bit of a conflict of interest but he did help me get my rent down by a good chunk and I got a decent amount of tenant improvement. I found a 1200ish sq ft place, and as an extra stroke of luck, my business neighbors include several medical ancillary services who are also cash based. The hardest part for me was timing on this. I couldn’t start looking too early because I didn’t want to pay rent before starting and I also didn’t want to start too late because I needed a physical address. I ended up picking the place end of April and signing the final lease mid May to start June. I got two months of abatement, so my payments don’t start until August.
Paperwork mountain: Business bank account, malpractice, CLIA waiver, local business license, GPO application (LabCorp and McKesson), lease review. All these forms hit around the same time and really made me question if I really wanted to open a business. I have always and will always hate filling out forms.
Spending abyss: For the most part, I’ve been able to keep my costs low. My biggest expense to date has been furniture. I went cheap with Amazon and Ikea. My medical furniture came from a used and refurnished medical equipment shop a mile from my office. Most expensive single item was the procedure/exam table coming in at just over a grand. There are some lucky people out there who get free or significantly discounted tables, I was not one of them.
Patient software: I’ll be using Cerbo, Spruce, and Hint. Other EMRs I considered were Atlas, Elation, Athena, and Akute. Alternative to Spruce I considered were using the Cerbo patient portal or Google Voice. Alternatives to Hint I considered were Bluefin or just using Stripe by itself via Cerbo.
This should be most of the major steps that’s gotten me to where I am now. I just finished residency last week and have been up to my eyeballs in moving both personal stuff and office furniture. Next week I’ll probably write about the furniture and design of my office. Until then, I hope you’ve enjoyed a view into my DPC experience. Again, feel free to reach out. Always happy to engage on any topic.