Podcast Episode 20 – “Can You Have a Successful Direct Primary Care Practice and See Only 5 Patients Per Day?” with Dr. Paul Thomas

Direct Primary Care with Paul Thomas

Episode 20 – The Direct Primary Care (DPC) model is disrupting the marketplace of the modern healthcare industry.  It’s a good thing too, since the U.S. is projecting a massive shortage of physicians over the next 20 years.  Dr. Paul Thomas has become a national expert in the DPC model, having successfully built his own direct primary care practice over the last few years.

In this model, he sees 5-6 patients a day, makes a middle six-figure salary, and has tremendous patient satisfaction scores.  If that sounds too good to be true, it almost is.  Work less and make good money?  And it’s better for your patients?  And it saves them money too?  No, this is not a scam, this is a phenomenal business model!

Whether you’re interested in direct primary care or not, this episode has got some great information for you!  Dr. Thomas shares his incredible business savvy to help us learn how we can modify our own practice to make more money, have a better lifestyle, and yet still help our patients more!


“Direct primary care is ‘concierge medicine for everyone else.’  It’s a membership model for primary care that makes health care affordable for the average person.”

 – Dr. Paul Thomas


Listen to the episode and leave a review on Apple Podcasts


Meet Dr. Paul Thomas

Paul Thomas


Dr. Paul Thomas is a board-certified family medicine physician practicing in Corktown, Detroit. His practice is Plum Health DPC, a Direct Primary Care service that is the first of its kind in Detroit and Wayne County. His mission is to deliver affordable, accessible health care services in Detroit and beyond. He has been featured on WDIV-TV Channel 4, WXYZ Channel 7, Crain’s Detroit Business and CBS Radio. He has been a speaker at TEDxDetroit. He is a graduate of Wayne State University School of Medicine and now a Clinical Assistant Professor. Finally, he is an author of two books Direct Primary Care: The Cure for Our Broken Healthcare System and Startup DPC: How To Start And Grow Your Direct Primary Care Practice.


Contact Dr. Thomas:

Buy the books!

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Take the course!

New courses: Startup DPC Courses on starting and growing a direct primary care practice: https://www.startupdpc.com/take-action

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Featured Online Community: Concierge Medicine Today

Concierge Medicine Today is the first online news and media outlet providing news and education about the benefits, cost effectiveness and value of concierge medicine/retainer medicine or direct primary care practices across America.


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Show times

  • 00:00 – Introduction to episode 20.
  • 01:26 – Subscribe to the podcast, and please leave a review!
  • 01:52 – Join the “Business and Personal Finance for Physicians and Dentists Facebook Group”
  • 02:22  – Get free disability insurance quotes from Pattern Financial.
  • 03:48 – Introduction to Dr. Paul Thomas.
  • 04:55 – Why did Dr. Thomas decide to pursue a career as a DPC doc?
  • 05:37 – Doctors need to understand business so we can take medicine back from administrators.
  • 06:56 – Direct primary care is “concierge medicine for everyone else.”  Direct primary care practices bill patients a small monthly fees that is nearly all-inclusive.  It’s a membership model for primary care that makes health care affordable for the average person.
  • 09:30 – Bureaucracy contributes significantly to physical burnout, and direct primary care can be the cure for that.
  • 10:39 – DPC is a great option for the 20% of people who are unsatisfied with their insurance and want to have a less traditional option for their health care.  It’s also really great for people in the income range that disqualifies them from Medicaid but can’t afford their traditional health insurance.
  • 12:34 – As much as half of the U.S. population may see significant financial benefit from switching from traditional primary care to a direct primary care model.
  • 13:39 – There’s no limit to how much the cost of health insurance can increase in a year.
  • 14:30 – DPC can offer opportunities to incentivize more medical students to consider primary care as an option.
  • 15:11 – The best part of the DPC model is the autonomy that the model provides.  A traditional primary care practice requires a panel of 2,400 patients and physicians have to see 1% per day (24-25 patients per day)
  • 16:58 – It takes relatively little money to start a DPC practice.  Dr. Paul Thomas was able to start his direct primary care practice with just $20,000 down.  
  • 17:49 – #1 limiting factor that would make someone not want to go into direct primary care: large student loan debt.
  • 18:35 – The DPC model can work in rural, suburban, and urban areas, even in low-income areas.
  • 20:03 – A direct primary care practice saves hundreds of hours per year not having to deal with the insurance companies and their endless paperwork.
  • 21:02 – The average cost for a patient in a DPC practice nationally is $82/month.  In low-income areas, that can be closer to $50/month.  
  • 22:04 – The first step in building a DPC practice is writing a business plan.
  • 23:00 – $600/year x 500 patients is a top-line revenue of $300,000.  That number goes down with taxes and costs.  If you can keep costs low, you can make over $200,000/year.  Depending on where you live, rent may be high and you may have to scale your prices to meet costs.
  • 26:06 – If you’re thinking of starting a DPC practice, you need to consider why! 
  • 27:38 – Make sure you have good branding and marketing to bring patients into your practice.  Be sure to synchronize your social media handles.
  • 29:47 – Dr. Paul Thomas says, “My DPC practice offers assurance, not insurance.”
  • 30:19 – He trains his patients to find him during normal business hours and respect his time.  In doing so, he’s comfortable giving out his cell phone number and his email to his patients.  He’s made it possible to offer that service to his patients and yet have protected family time.
  • 33:58 – When he takes a vacation by himself, he is still able to do so, even as a solo doc.  He emailed patients several times in the month leading up to that so he could take care of things before or after.  For other urgent issues, he had a handshake agreement for his patients to go see another DPC doc or go to an urgent care center.
  • 38:42 – In the DPC contract, Dr. Thomas includes clauses that require patients to be respectful of the access they receive.  The contract also includes clauses allowing either party to terminate the contract at any time.
  • 37:30 – Dr. Thomas is able to obtain a dispensing license for $40/year to allow him to dispense medications.  He uses a company called Andamed to get access to wholesale costs of medications.
  • 39:16 – He has a similar deal with Quest labs to allow him to get labs at cost for his patients.  He also has a similar arrangement for radiographic imaging tests for his patients.
  • 40:38 – The DPC model is proving that the American healthcare industry is ripe for disruption.
  • 41:07 – Dr. Thomas does in-office procedures for free as much as possible.  
  • 43:08 – Because they don’t deal with insurance companies, they don’t have to do any billing or coding.  Everything is included in the membership fee and that keeps things really simple.
  • 45:13 – Consulting with specialists may require that patients have a small insurance policy to cover specialty consultations.  Dr. Paul Thomas also pays a small monthly fee for a service called Rubicon that gives him unlimited access to specialists for consultation.
  • 46:19 – Patients in the DPC model should still have an insurance policy to cover catastrophic illness/injury.
  • 47:04 – Dr. Thomas does house calls but charges a small fee for that special service.
  • 47:18 – He doesn’t have additional revenue streams at this time.
  • 48:34 – Dr. Thomas gives his parting advice for people considering starting a DPC practice.
  • 51:25 – Summary of the episode
  • 52:48 – This week’s free resource: “The 10 Day Simple Clinic Makeover”
  • 54:00 – Featured online community, “Concierge Medicine Today”
  • 58:13 – signing off


Listen to the Next Episode

Life Insurance with Dr. Stephanie Pearson

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business, dentist, entrepreneur, physician, practice management, primary care

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