Welcome back DPC rebels and resistance fighters. Today, we dive into the second part of connecting DPC physicians and benefits advisors flipping the script to discover what advisors should learn from DPC physicians to be assured they have the real DPC magic to save employers (and employees) time and money. Trust me there are more and more imposters out there claiming the DPC mantle. How does an employer or a benefits advisor really know a DPC physician is really good? Let’s look at conversations advisors should have with DPC docs to find out and identify any red flags. 

• Tell me why DPC works for you. Tell me your story of DPC. 

            Every DPC physician I know has a unique journey into the DPC model. Most suffered in the soul-sucking system for years before finding salvation. However, over the last five or six years more and more physicians are starting or joining DPC offices right out of residency. All of them have deep convictions on why they chose the DPC model. Most made huge sacrifices to leave the system as well as assuming massive risk doing it. Hearing their story will go a long way to understanding their commitment to patient-centered health care. Also, hearing these stories, many times will connect you with other healthcare professionals that you may know. These professionals can confirm the DPC docs story and give you insight into past history of that physician. It is always good to hear from other medical professionals about the abilities of the DPC physician you are contemplating working with. Be ready for a long conversation here as most DPC physicians could talk for hours about the direct care model. 

• How long have you been in practice? How long have you practiced here in this community? How long have you been doing DPC? 

            Time is a great educator. Advisors need to know how long the physician has been practicing, and how long out of residency. Are they right out of training or have been in private practice for 20 years? Now, it might not make a speck of difference for some physicians but more time in practice (more experience) does lead to honing the craft of medicine. Also, it is important to know if the physician has been practicing in the area for decades or is brand new.  If new, why is that? What brought them to this area?  Obviously, physicians practicing in the same area for 10 or 20 years would be beneficial for making other healthcare connections as they should know the health community well. 

            If they are doing direct care, good to know how long. If they have been doing DPC for years, then that is a really good sign, especially if their office is an independent clinic. Running a business is tough and DPC physicians that have made it work for years have the right stuff, the “it” factor. They understand the model and what it takes to make it work and bring value to patients. These are all positive markers for success. 

• Tell me how your office operates in the DPC model. 

            You are looking to understand the business model they are using in DPC: solo doc practice? multiple physicians? Is it “pure” DPC or “hybrid”? Are their Nurse Practitioners (NP) or Physician Assistants (PA) doing the work? Benefits advisors should explore how the DPC clinic is set up and run. A “pure” DPC is one that fully operates outside of insurance and Medicare. They have cut all ties with insurance plans so as to focus solely on the people who pay the bills, patients. Meanwhile, “hybrid” clinics accept some insurance and offer a DPC plan too. This can be complicated as physicians are literally treating patients differently based on how they pay the clinic. This is a moral quagmire for most physicians. Also, hybrids require more staff and therefore overhead to deal with burdensome insurance coding, billing, and paperwork. So, it is harder and more costly to operate this business which is the reason physicians left the system in the first place.

            Advisors also need to know who is providing the care–physicians, NPs, PAs, or possibly a mixture of these. Discussing the difference in training for these provided is beyond the scope of this article but training and experience are critical for the proper care of patients. More and more third-party corporate companies are forming direct care clinics operated by nurse practitioners for the same fees (sometimes for higher fees) than independent physician-owned clinics. Make sure you are comparing apples to apples. An independent physician-owned DPC is radically different from a clinic owned by a corporation that hires physicians or NPs to help patients. Independent physicians operating a pure DPC have a lot of skin in the game to take excellent care of patients for reasonable fees. So, be sure you are clear on the office operation. 

• What services do you provide in your DPC clinic? 

            How much care can be done at their DPC office is the question. The more experience and training a physician has the more they can keep patients in their office without referrals. Ideally, a DPC physician can provide about 70-80% of the care patients would need thanks to the extra time the DPC model offers. An experienced family physician can do orthopedic and skin procedures as well as pediatrics, women’s health, allergy care, and urgent care issues (and so much more).  Also, many DPC clinics provide discounted labs and generic meds which saves patients time and money. Finally, advisors need to be clear on all the “outside the office” services provided such as after-hours care, texting, email visits, video visits, and phone visits. Not all DPC clinics will be the same but these are some good baseline services to consider to keep costs low and referrals down. 

• What is your plan for growth? Do you have space to add hundreds of new patients? 

            This one can sneak up on DPC clinics and advisors. It can be difficult to estimate how many employees will choose to use DPC since it’s so new. Everyone needs to know how many patients the DPC clinic can safely take. As a general rule, most DPC physicians carry about 500 to 600 patients. With this in mind, is there room for growth? Is there a plan for growth, such as hiring a new physician or NP/PA? Is there physical space in the office for more patients? Over time as more employees learn about the benefits of DPC, then more will join. DPC clinics need to be ready to add more patients. Advisors need to be certain growth is possible. 

• Does the DPC physician have any previous experience working with employers? 

            This one could be the cherry on top. Find out if the DPC doctor has worked with other employers in the area and how those connections played out. Advisors can speak with other employers to see how they evaluate the DPC doc. If there are other larger employers using the clinic, speaking to their benefits advisor and human resource team could offer valuable insight. These are the most valuable reviews you can get. 

So, there you have it. Some serious questions to gain insight into a DPC physician’s expertise and practice style. It will take both the DPC doc and advisor working together to create a magical health plan. Keep up the communication. Keep learning. And keep DPCing.