Logistics and marketing of your direct care practice

Focusing on details like hiring, delivery and marketing for your practice is key.

Now that you have laid the business foundation for opening a direct care practice, it’s time to focus on operational details such as hiring staff, supplying your clinic, and marketing.

Hire staff

Once you’ve found your practice location, the next step is to hire a great associate, unless you’re planning on opening a micro-practice without help (which I don’t recommend if you’re hoping to have some sort of work-life balance!) .

I recommend hiring and onboarding someone to act as your “right hand” from day one. For some doctors, the idea of ​​paying an employee before earning an income is hard to swallow. But remember, you are becoming a business owner – the business should not own you! Having a staff member on site during business hours gives you the freedom to be elsewhere when not actively seeing patients. For example, you need time to focus on business tasks, such as B. Attending community events to recruit new patients. Having employees also gives you the flexibility to work part-time or spend time on other interests.

Because payroll is one of the largest expenses of running a medical office, you should consider hiring just one employee to assist with both clerical and clinical duties. This can be a medical worker such as a medical assistant or nurse who is trained to perform clerical duties, or conversely, a dedicated clerical worker who can assist you when needed. Although there are pros and cons, I decided to hire an administrative assistant to run the office as I figured I could do all the medical aspects myself such as: It turns out that I really enjoy these aspects of hands-on patient care, especially since I have the extra time as a direct nursing physician.

The most important part of hiring is finding someone who is dependable, trustworthy, and has a bright personality that reflects well on your practice. You should fully understand the direct care model in order to enthusiastically explain it to potential patient callers. I’ve found great employees through word of mouth and online recruitment sites like Indeed.com. Be sure to check references carefully and don’t ignore any warning signs when hiring.

supply of your practice

Now it’s time to set up all your utilities such as electricity, water, telephone and internet. This is where having this employee comes in handy – you can delegate the responsibility of contacting utilities and planning the facility. Your phone number is vital, as most patients begin the doctor-finding process by asking for information. You can install a direct phone line or use a voiceover internet provider. Whichever service you use, you should be able to flexibly transfer calls when you’re out of the office. Having the best high speed internet service you can find in your area is a necessity in today’s electronic age.

There are a variety of excellent and affordable electronic record keeping systems, many of which also integrate billing services and allow you to communicate with patients via email and text. Most are cloud-based and cost a few hundred dollars a month at most. Because you don’t report information or send bills to third parties, you don’t have to comply with expensive and cumbersome systems that reflect wise use.

While you’ll likely opt for an electronic, “paperless” system, medical offices still seem to generate a lot of paper. For this reason, I highly recommend investing in an industrial copier with built-in faxing and scanning, and paying a company to collect and shred your paper waste. My lease-to-own of a refurbished copier costs about $75 per month and paper shredding costs about $35. You must also hire a company to collect your medical waste per the requirements of your state health department.

Next, make a list of the office furniture and supplies you will need. The more you can beg, borrow, and virtually steal from Craigslist and Facebook Marketplace, the better! I bought and re-covered my exam table from a tattoo shop that was closing and got my EKG machine from a retired plastic surgeon for pennies on the dollar. You should open an account with a medical supply company to get the basics like point-of-care tests, office medications, and bandages, but don’t forget to check out sites like Amazon, which are sometimes cheaper.


The best marketing tool for your practice is YOU. Patients seek a relationship with a caring doctor; All you have to do is show them you’re open for business. Make sure your new practice address is listed on your State Board of Medicine, Google, and doctor rating websites. If you had a previous practice, send letters to your former patients to let them know about your new location. Send a press release to your local newspapers and media.

Don’t spend a fortune on advertising or marketing services – just start building a simple website (I built mine on Wix.com for $4 a month) and develop a social media presence. Create a Facebook business page and start creating content with photos of your practice and videos talking about your new model. Connect your practice to local groups on social media and look for opportunities to speak to community groups. If you have a particular interest or niche in a specific patient demographic, seek out those patients and share your model with them. Consider contacting small businesses with fewer than 50 employees to offer your services to the employer at a discounted rate. For example, my practice serves the employees of a landscaping company, a chiropractic practice, a law firm, and an insurance company.

Interacting with your community and sharing your practice model is a great way to recruit new patients. Refine your “elevator pitch,” a 15- to 20-second blurb about how direct care can help your prospective patients by providing affordable, accessible care and returning to a true doctor-patient relationship.

Keep in mind that not everyone will see the value of the direct mentoring model — and that’s okay. Be prepared for rejection and even criticism from some patients when they learn that you do not contract with insurance companies. Stay professional and positive and don’t get discouraged. Focus on providing the best possible care to patients who will appreciate what you have to offer – word of mouth from your current patients is one of your best recruiting tools and will help you grow quickly.

legal issues

As with any medical clinic, you must be aware of federal and state legal requirements. For direct care, many states require patients to understand that your clinic is not acting as an insurance plan. Creating a detailed patient agreement outlining your services and clarifying patient responsibilities is essential. DPC Frontier lists some of the most common legal pitfalls, but it’s important to be aware of all state-specific laws regarding medical practice and direct care.

If you wish to provide direct care to Medicare-eligible patients, you must opt ​​out of receiving payments from Medicare. I will have more details about this process in my next article.

Rebekah Bernard MD is a general practitioner in Fort Myers, FL, and the author of How to become a Rockstar Doctor and Physician Wellness: The Rock Star Doctor’s Guide.