How Wellscape Direct MD Operates as a One-Person Practice

Dr. Linnea Meyer runs Wellscape Direct MD in Boston as pure direct primary care, and the team size is exactly one. A year and a half in, she looks after 50 to 100 patients aged 13 and up, from a small subleased office near TD Garden with exposed brick that feels less clinical than the usual medical suite. Some patients live around the corner and others live hours away and stay with her by telemedicine because they knew her before. She talked to us about texting, telemedicine, and the technology that lets a solo physician provide care wherever her patients happen to be.

About Wellscape Direct MD

Practice Location: Boston, Massachusetts
Practice Model: Direct primary care (DPC)
Years of Operation: 1.5
Team Size: One! Just me!
Panel Info: 50–100 patients. I’m pure DPC. I have patients who live hours away who have known me in the past, and make use of telemedicine to stay in touch; others are in the greater Boston area, and some live right around the corner! I see patients 13 years old and up, and my demographics run from 18 to 70+, with a good split between genders and across socioeconomic statuses.
Practice Space: I’m in the North Station area, across from the TD Garden. I sublet a small office space there from a physical therapy group, and it feels homier than the traditional office: it has exposed brick which brings in the old-Boston feel, space to sit in a chair to have a conversation, and dark chocolate and hot tea that are always available!

Q+A with Dr. Meyer

Spruce: What is your favorite part of practicing medicine in the DPC model?

Dr. Meyer: Interacting with patients! Healthcare intersects many aspects of our lives, and I believe that the best healthcare is provided in the context of a strong patient-physician relationship, so that we can better understand how the many facets of life impact a person’s health and perspectives. The DPC model is great for this—it affords us adequate time with our patients and allows them to have more access to us for ongoing conversations about their health, wellness, and care decisions.

Spruce: How has telemedicine enhanced your practice?

Dr. Meyer: Telemedicine makes it convenient for me to stay in touch with my patients, to address their concerns when they arise, and to avoid unnecessary trips into the office (we can handle a lot of things by text, phone, or video).

Patients also love it—most are accustomed to texting these days, so having a secure messaging system fits right into that. They appreciate the convenience of these options, saving them from losing time from work and home duties, as well as preventing needless worry from long waits to get in to see their doctor.

Spruce: What has been most helpful about using Spruce?

Dr. Meyer: Having my phone, texting, and secure messaging all come into one place. Since I run all of my communications through Spruce, I can see and keep track of who is trying to reach me, whether it’s by phone, SMS text, or secure messaging. Convenient, simple, secure!

Spruce: What percentage of your patients text or secure message you? How do you keep that organized and have “off time”?

Dr. Meyer: The majority of my patients appreciate and utilize the texting/secure messaging options. I encourage secure messaging, and most are comfortable with using an app.

It is important to try to set some boundaries so that I can have a little downtime—life-work balance is something that many of us DPC docs are always working on, as we love being accessible to our patients. So, to that end, I make it clear that messaging is not for urgent issues, and the expectation for response is up to 72 hours (most often to account for the weekend; typically, I respond within the same day). Patients are generally very respectful of my after-hours time and, if they do need to reach me, are typically quite appreciative of my availability—they are aware the practice is just me!

I also advise patients to call if they need to reach me right away. It’s great that the Spruce voicemail system allows patients to leave messages with an “urgent” indication, notifying me that someone requires an immediate call-back.