How to Scale your DPC Practice to 800 Patients with One Provider

Meet Dr. Rob Lamberts

Dr. Lamberts was one of the first physicians to open a Direct Primary Care (DPC) practice when he started his clinic in 2013. Located in Augusta, Georgia, Dr. Lamberts’ practice now has more than 800 patients and is growing quickly. When he’s not caring for patients, Dr. Lamberts runs a blog filled with humorous healthcare poetry. Dr. Lamberts sat down with Spruce to talk about communication, technology, and how to scale your DPC practice.

Dr. Rob Lamberts

Spruce: Thanks for speaking with us today, Dr. Lamberts! To start, tell us a little about your practice.

I’ve had a DPC practice for over six years. I’m one of the older DPC practices out there. I’ve been doing it since February 2013 and I’m up to 820 patients right now. It’s growing very well. It’s just me and two nurses, and we recently added another physician. We’re all growing like crazy right now.

I started a DPC practice when there were 100 or so of them in the country. I talked to three or four different folks to get ideas as to how to run a practice, but I didn’t have the right tools. I didn’t have a good EMR system, I kind of made it up as I went along. As we grew, so did the tools for DPC.

Spruce: How did you grow to over 800 patients with one physician?

My practice wasn’t feeling full at 800 patients. So my answer was that I had to think outside of the office. I had to offer communication, and I had to have tools to handle problems in the most efficient ways.

Patients will send me a message and say, “I need to be seen,” and the knee-jerk reaction is to schedule an appointment. Part of that is because that’s the payment paradigm that’s been here forever, but that’s not the way it works in DPC. Plus, there’s also the idea that you have to be nice to the customer and see them when they want to be seen.

Patients often think that being seen is what they need, but the reality is they don’t need to be seen, they just want to be heard, they want to communicate.

I mean, sometimes we do need to convince people to come in — it’s a balance. But my daily schedule in the office is not that busy. Instead, every day there are secure messages and texts and phone calls and emails, which I’m trying to figure out how to best handle. It’s the new challenge of how to efficiently communicate well.

We only allow for two new patient appointments per week, which is a great problem to have! I keep looking at my numbers and noticing that we don’t have people leaving, and I don’t want them to leave. At some point, we’re going to have to figure out a strategy for adding other physicians or PAs within the practice. I want to keep growing, because I’ve always been of the belief that if you’re not growing, then you’re shrinking. But there’s no doubt that the center of our practice is not the office visits, it’s communication.

People will say communication is very important for healthcare, and the answer is that it’s not “very” important for healthcare; communication IS healthcare.

You can’t do healthcare without communication, because it’s about listening, it’s about communicating information to the patient, it’s about accurately getting and sending out information. And whatever tools you can use to do that have the power to really help.

DPC Practice Growth and Technology

Spruce: How have you utilized technology in your practice?

When you’re adopting technology, you don’t want it to get in the way of patient care. Sometimes, health tech becomes the centerpiece of the practice. That’s what electronic medical records have become in typical healthcare models. It’s all about the record and not the patient — the patient is just data for the record, not the other way around.

The first thing you want is a system that understands the patient and meets their needs with the least amount of friction possible. When you pair the tools with a new paradigm, it enables you to greatly enhance your quality of care.

What are we selling as DPC doctors? The product is access. We’re giving patients access to me, to our staff, and to high-quality care.

To do that, you have to have the right tools that enable you to give access to patients in a way that they actually value.

Spruce: Thanks, Dr. Lamberts!

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