I thought these details might be useful as an FYI for those curious to become independent physicians.
I worked in an insurance-based practice, primarily Medicaid, for 5 years in Happy Valley, OR before going solo/membership/no insurance 4 years ago here in Portland, OR.
I have around 60 members and accept just one new member per month, so I keep a wait-list. I spend an hour with patients (sometimes 30 min) because I do a lot of lifestyle counseling and mind-body teaching.
Most people attracted to my practice need the high-touch therapeutic relationship I offer, so they have either complex health probs or comorbid anxiety/depression etc.
I don’t do procedures but am a “cognitive specialist,” if you will.
I charge $3000 for the first 3 months of unlimited care (we do lots of labs, lots of counseling, several visits, detailed physical exam, coordinate with their specialists, preventive med stuff like coronary CT scan if indicated, really get everything ironed out), then it’s $200/mo thereafter.
This covers 8 visits per year; more are $300/hr $200/half hour.
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Just weeks ago, I increased my 30 old patients who paid less than this monthly, up to the current $200 rate, and only ONE is leaving. One who I’d been giving a discount for years said “I don’t want to lose you as my doc!” and didn’t complain. I was honestly hoping to “clean house” and have a few more leave, silly me!
I was offering unlimited visits until recently when I calculated that over the past year I was being paid on average $100 per hour.
For a small practice of highly anxious and/or complex people, or simply higher utilizers, the unlimited care thing was going to drive me into the ground.
Hence the new limit on visits so I get paid at least $300 per hour-long office visit, plus unlimited portal/text access in between (which honestly is most of my day, people love their access that way!)
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The cost structure, in my case, is not what attracts nor repels people.
Most people didn’t mention the price change, just one couple has questions about the number of visits included in that price…
I share this as a perspective of what different people are doing… I am not actually DPC (see our Private Practice section for more on DPC, or the series Their DPC Stories), but have developed my own style and structure to match my personal preferences and strengths/weaknesses. I don’t advertise, people mostly find me on Google or are referred by another member.
Just some food for thought for those who are curious.
I charge $3000 for the first 3 months of unlimited care, then it's $200/month thereafter.
You don’t have to copy anyone else’s style to be successful and have a great life!
I don’t work excessively, and am a good example of someone who eats well/moves well/sleeps enough.
I don’t have kids or massive financial commitments, so I have been able to grow slowly and stay solvent.
Finally, for those curious, people CANNOT get into a doctor around here, and cannot get a relaxed visit, so the bar is REALLY low for how to wow people…I think I have over-delivered out of insecurity but honestly just keeping my schedule open by limiting membership is worth at least what I charge.
