Determining the Scope of Practice of Your DPC Practice

Expand your mind

Not everything has to be 100% covered by a membership (though of course, you should include as much as is feasible). Many practices offer additional services—procedures, OB, physicals, preventative health screens, etc—on a cash-pay fee-for-service basis. Consider what to include in the membership, what to provide at-cost, and what to charge extra for.

As a DPC doctor, you're the linchpin of your patients' care. Watch this excellent talk by Drs. Lassey and Tomsen on expanding your scope of practice. Some services are a great way to attract patients, others can be lucrative add-ons to your practice. Consider expanding your scope to include: Consider whether you'd be willing to offer the following services:

In-office dispensing

A lot of practices do this. In-office dispensing is a great perk to offer your patients: if saves them trips to the pharmacy and a lot of money besides. Some states also require licenses, others impose limitations, and other make it nearly impossible - see DPC Frontier's state-by-state legal analysis for description.

There may be additional administrative overheads associated with buying and tracking Rx inventory, but it doesn't have to be burdensome. You can purchase pre-packaged pharmaceuticals from wholesalers like AndaMeds or Henry Schein, and re-distribute them to patients in the original packaging. If you prefer more fine grained control, you may need to purchase a pill-counter and Rx inventory tracking software.

Note that offering some of these services may raise your malpractice insurance premiums. Also, many states will require an inspection by the pharmacy board — be sure to look up your state's policy on that.

joint injections

minor procedures

For instance: vasectomies, hemorrhoid excision, abscess I&D, and cryotherapy.

casting

cosmetic procedures

OMT

vaccines

immigration/DOT physicals

stress/VO2 max testing

migraine treatments

bone density testing

body composition analysis

travel medicine

phlebotomy

It's often worth putting in the time to learn phlebotomy, especially if you're starting off as a one-person operation. Look for classes at local community colleges or ask a nurse to teach you. This will save your patients a ton of time waiting around in a lab.

CPAP/sleep testing

coordination of hospital care

Patients will be eternally grateful to have someone truly in their corner during a medical emergency. If you want to do this, you should start researching the credentialing processes at nearby hospitals.

obstetrics

Yes, some DPC practices do this!

Determining the Scope of Practice of Your DPC Practice

Scope of practice