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Hindsight is Maybe
20/30...
What was…
• Fee For Service
• 25 years of practice
• 4000 patients at time of conversion March 2014
• Staff of 11
• Own building
• Source of Income
• FFS
• Clinical Trials
• Laser Treatments
When We Started…
• Direct Primary Care
• Started with 325 Patients
• Staff of 6
• Source of Income
• Memberships
• Residual FFS
• Laser Treatments
• Clinical Trials
• Line of Credit
Where We Are Now…
• Direct Primary Care
• Now 625 members
• Staff of 3
• Business Relationships
• Source of Income
• Memberships
• Urgent Care
• Cliincal Trials
Where We Will Be…
• Direct Primary Care
• 700 members per provider
• Staff of 3
• Increased Business Relationships
• Multiple Locations
• Source of Income
• Memberships
• Clinical Trials
Hindsight
The Apologetic Tour
Overestimated
Patient Number
Conversion
Diminished Cash Flow
Dependence of Banks
Partner Early
with Benefits Expert
The prudence of the
best heads is often
defeated by tenderness
of the best hearts.
-Henry Fielding
Foresight
Early Adopter
Relied On Old Patients
Good Moonlighting
Job
Found Benefits Guru
Surrounded Myself
With Leaders
Good Choices with
Tech Tools and EMR
Developed Good
Website
Advice Going Forward
Assume 7-10% of
Existing Practice will
make change with
you
Cash Flow for 6-12
months
More Education than
Marketing
Good EMR and
Communication Tools
Limited Staff
www.scotlandfamilymedicine.com
Direct Primary Care Practice Transformation: Lessons in Hindsight and Foresight

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