Where Do I Start With Direct Care?

Where Do I Start With Direct Care?

Tea Nguyen, DPM shares 9 steps to get you started with your Direct Specialty Care practice.

So, you hate insurance.

There’s no doubt something is very wrong with the current healthcare system we have here in the US. My friends from afar tell me when they travel to the US they avoid having to use our medical system because prices are astronomical and unpredictable. They always carry travel insurance and hope to never need to use our healthcare system. 

I don’t blame them.

Unfortunately, many of us live here and practice medicine within the constraints of insurance and we’re sick of it. We are literally working ourselves sick within this system that interferes with our ability to help our patients. We’re having to see 30-60 patients a day, spending a few minutes per person, and taking home work to complete charting documentation for insurance in order to get paid. Even when we check all the boxes, we remain at risk for audits and requests to pay back alleged overpayments, and get penalized if payment is delayed, and it doesn’t even matter if we were right! We waste a lot of time catering to insurance companies who literally do not care about patients.


“We’re having to see 30-60 patients a day.”


The hoops we need to jump through to get patients the medications we prescribe, or the imaging studies to determine if surgery is the next step, or having our patients wait for months to see a specialist is quite the circus. This happens with both government assisted insurance and private insurance. It’s a real head scratcher that even after pouring money into health insurance premiums directly or through taxes, it will still take months for any medical attention and those visits last on average 7 minutes. There’s not enough time in the insurance model to give thoughtful care without burning out. 


The hoops we need to jump through to get patients the medications we prescribe, or the imaging studies to determine if surgery is the next step, or having our patients wait for months to see a specialist is quite the circus. Click To Tweet


But I know you know that this is a problem. That’s why you’re here, to see how you can untangle yourself from this convoluted way to practicing medicine and do things simpler with Direct Care. You might be asking, 

“Where do I start?”


It’s not as complicated as you might be (over)thinking it might be.

  1. Start with a deep desire to make Direct Care work. You have to really want it and believe that this is THE way. If you go in with one foot in the water and the other still on land, how will you ever learn the skills to swim? It’s challenging isn’t it? Owning a Direct Care specialty practice is the same way, going all in is what makes this model so rewarding. No more answering to insurance!
  2. Establish your LLC, PLLC or legal equivalent. Protect your personal assets from your business assets. If you were to get sued through your business and your business was not established as a separate financial entity, all of the things you own that had nothing to do with your business are at risk. You can get a health care lawyer to establish your LLC. Make sure you check your business name for trademarks rights https://www.uspto.gov/trademarks/search
  3. Set up your business location. Will you be providing medical services in person or virtually? If in person, you can quickly register your Google Business online (you need a business address) so people can start giving you online reviews. If virtually, consider getting a virtual business address separate from your home to protect your privacy, like https://www.regus.com/en-us/united-states/california/virtual-offices Plug in your respective state. Alternatively, see if your neighborhood doctor friend will allow you to share their business address until you settle in. 
  4. Create your budget. What do you need to purchase or lease to operate? The bare minimum to get started in a Direct Care practice includes
    1. EMR or Google Business if you’re very organized
    2. Phone line – VOIP or Google Voice (free)
    3. Laptop
    4. Adobe Acrobat Reader – for digital intake forms in person or online forms with JotForm (if not included in your EMR)
    5. Payment system – check, cash, Stripe/Square
    6. Rent
    7. Utility
    8. Wifi
  5. Marketing plan. How will people learn about what you do & how can they book an appointment?
    1. Word of mouth, tell your friends, local docs, local business networks
    2. Website – build it yourself easily with Wix, Squarespace, WordPress etc. Deal with SEO later.
    3. Business card & brochure – create through Canva or professionally


    You can now watch the lectures our verified health professionals deliver anytime, anywhere. Choose from various topics using our filters, and sit back and learn.

  6. License to practice medicine etc. You’ll need your usual things to practice medicine like state credentials, DEA to prescribe, CME for maintenance, and local city requirements (business license). Shop around for malpractice & property insurance if renting office space. An insurance broker can help with general property and worker’s comp insurance (state dependent). Your state or national specialty association will have these resources and discounts also. 
  7. Find people like you, including Direct Specialty Care & Direct Primary Care docs. Trusted resources include Facebook support groups like Specialists for Direct Care or DSCalliance.org. Check out The Direct Care Way Podcast and My DPC Story Podcast. Connect with all cash practices, including alternative medicine. They get it. 
  8. Read about marketing & other business books. Read like you’ll be graded but instead of a grade, you’ll get patients if you pass. Understand how patients think, the language they use, places they go to find solutions, learn all of that. It’s time to switch your doctor-language brain into a consumer-language brain. Breakdown medical jargon into concepts and ideas that the general public will appreciate and gravitate towards. 
  9. Create assets. Encourage people to learn more about you and what you offer by creating an asset (library) to refer to. It may be an informative blog, YouTube channel or podcast. You won’t know what’ll work until you try it and all of these are free to set up. These assets are working for you around the clock. It’s an efficient way to tell people exactly what you do, even while you’re sleeping.


Is there more to this list? Absolutely but it’ll come up as you gain momentum. The hardest part is just starting. Many first visits will be a consultation.

So if you’re a proceduralist like me, you don’t necessarily need to have all of the latest technology to get these conversations started. Just start.

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Sherita D. Gaskins-Tillett, MD

11/02: A Weekend For Me

A Weekend For Me is a time-out for professional women to rest, reconnect with themselves, define their priorities and vision a life that they love.

Tea Nguyen, DPM (Aptos Headshot Photography)

Tea Nguyen, DPM

Direct Care restores the patient-physician relationship by simplifying access to care.

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This learning experience is powered by CMEfy - a platform that brings relevant CMEs to busy clinicians, at the right place and right time. Using short learning nudges, clinicians can reflect and unlock AMA PRA Category 1 Credit.

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