Is Direct Primary Care possible for national guard?

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As referenced, I'm in the guard and have been assuming that would kill doing dpc...I'm just searching for some level of comment/confirmation to make sure I'm not writing something off based on mistaken assumptions. I'd love the long term relationship of FM, I love the running of my own business and I love taking the government out of the equation.

1. I figured it wouldn't work because if I'm a single doc shop, covering myself with locums for 4 months at a time would (likely?) be devastating to the practice
2. My guess is small groups won't want to deal with the hassle of a partner deploying

(possibly unrelated....I'd only go FM if I could do DPC, if I get stuck dealing with the ACA and insurance I will bite the bullet and go to a more profitable specialty for my trouble)

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As referenced, I'm in the guard and have been assuming that would kill doing dpc...I'm just searching for some level of comment/confirmation to make sure I'm not writing something off based on mistaken assumptions. I'd love the long term relationship of FM, I love the running of my own business and I love taking the government out of the equation.

1. I figured it wouldn't work because if I'm a single doc shop, covering myself with locums for 4 months at a time would (likely?) be devastating to the practice
2. My guess is small groups won't want to deal with the hassle of a partner deploying

(possibly unrelated....I'd only go FM if I could do DPC, if I get stuck dealing with the ACA and insurance I will bite the bullet and go to a more profitable specialty for my trouble)
Whatever happened to 1 weekend a month, 2 weeks a year? Half jesting, but that sounds like a deployment type deal which I didn't think was usually a regular thing with the guard.

If you are going to be gone for 4 months straight every year, then truthfully I'm not sure any non-locums job will want you.
 
Whatever happened to 1 weekend a month, 2 weeks a year? Half jesting, but that sounds like a deployment type deal which I didn't think was usually a regular thing with the guard.

If you are going to be gone for 4 months straight every year, then truthfully I'm not sure any non-locums job will want you.
it's up to 4 months every 2-3 years....and that's pretty much the response I expected. Frankly, I would feel the same way if I was the non-guard partner in a small group. I knew this might be off the table when I signed up.....guess that hunch was correct
 
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it's up to 4 months every 2-3 years....and that's pretty much the response I expected. Frankly, I would feel the same way if I was the non-guard partner in a small group. I knew this might be off the table when I signed up.....guess that hunch was correct
I think you may have misunderstood me. When I say no non-locum jobs, I mean that in every specialty. I'm not sure a cardiology group (or really any specialty) would be happy about losing a partner for a third of the year. That's 4 months of increased call for everyone else and busier clinic at the same time. Potentially a very large group could absorb this without too much trouble, but even then they aren't going to like it.

Now that all being said, if its only every handful of years it could be worked with (4 months out of say 36 is much less unpleasant than 4 out of 12). For example, if you were the 4th person in a DPC practice, then when you're gone that only increases each other person's patient panel from 600 to 800. For a defined period of time, that's not the end of the world. Plus, most DPC patients would be quite understanding given the reason for your absence (assuming you give them some decent warning about it). Heck, it might even be a good patient recruiting tool if you played it right.
 
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I think you may have misunderstood me. When I say no non-locum jobs, I mean that in every specialty. I'm not sure a cardiology group (or really any specialty) would be happy about losing a partner for a third of the year. That's 4 months of increased call for everyone else and busier clinic at the same time. Potentially a very large group could absorb this without too much trouble, but even then they aren't going to like it.

Now that all being said, if its only every handful of years it could be worked with (4 months out of say 36 is much less unpleasant than 4 out of 12). For example, if you were the 4th person in a DPC practice, then when you're gone that only increases each other person's patient panel from 600 to 800. For a defined period of time, that's not the end of the world. Plus, most DPC patients would be quite understanding given the reason for your absence (assuming you give them some decent warning about it). Heck, it might even be a good patient recruiting tool if you played it right.
Oh, I caught that...the reason I say other specialties is that if I'm going to deal with having to do a large group with the insurance billing or go hospital employee, that I'll want more money for the hassle. No 3 person group is going to touch me...
 
Oh, I caught that...the reason I say other specialties is that if I'm going to deal with having to do a large group with the insurance billing or go hospital employee, that I'll want more money for the hassle. No 3 person group is going to touch me...

Understandable, money can make up for a lot of pain-in-the-ass.

The scenario I imagined for a 4 person DPC practice would be something I could see myself trying to make work. Now obviously that's not enough for you to pick a specialty on. I would suggest calling/emailing Josh at AtlasMD personally. He's surprisingly good at finding solutions, plus he has a 3 person practice and could tell you better than I if a 4th with occasional military commitments could be worked out.

This may be getting a bit personal, but is the Guard something you could/would leave in a few more years?
 
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Understandable, money can make up for a lot of pain-in-the-ass.

The scenario I imagined for a 4 person DPC practice would be something I could see myself trying to make work. Now obviously that's not enough for you to pick a specialty on. I would suggest calling/emailing Josh at AtlasMD personally. He's surprisingly good at finding solutions, plus he has a 3 person practice and could tell you better than I if a 4th with occasional military commitments could be worked out.

This may be getting a bit personal, but is the Guard something you could/would leave in a few more years?
My obligation has me in for quite some time...I'd be 7 years into private practice before I could get out
 
I would suggest calling/emailing Josh at AtlasMD personally. He's surprisingly good at finding solutions, plus he has a 3 person practice

awh shucks, now if i could get you to talk to my wife ;-) and we're going to be up to 6 doctors by the end of the year and 2nd location.
 
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Alright, so great question overall and a great thread.

In general I try to say "yes and how" rather than "no". That being said, I also used to think that only 1/2 of my ideas were good...now i know its closer to 10%...BUT i make it up on volume :)

1) VA Doc is spot on - you could definitely swing this as a positive depending on the group you're serving. This would be true for pre and post deployment. You could fill a practice with military families b/c you understand the soldiers side and the family side.
2) would it complicate some things? sure. But the sport of business is more about making obstacles work FOR you.
--if you're honest about it up front with the patients, they'll be more understanding than if you surprised them with it
--the social media side of marketing is...wait for it...this is pure genius....on the edge of your seat yet....SOCIAL! the NG involvement would be something so unique that you could talk about it, tweet about it, send pictures to your patients about it when you're away on training....people are attracted to interesting people.
--technology makes this a VERY small world
3) deployment - 4 months...ugh...that would be hard on the business....but not impossible.
--free memberships while you're deployed! do you have access to email while you're gone? you could still be involved in their care
-- or discounted
-- or portion of membership fees donated to soldiers groups, ptsd, etc
--2 words: ka. ching. :) if i was your partner and wanted to increase my salary by 25%?! nooice! sure its more work...but its a nice reward too
--600 pts per doc...4 doctor practice...your 600/3docs = 200 more pts/doc = 2 extra pts seen per day....DOABLE
--Not everyone who wants to serve, can. Maybe your partner's "serve" by helping you to Serve...My partner Doug is a great example of someone who really feels he missed out by not serving in the military...your partners might really appreciate the ability to help you out...

In general, my recipe for success is
1) if it seems hard, its probably the right way
2) if someone tells me it can't be done, thats proof that i'm doing something right :)

"The reasonable man adapts himself to the conditions that surround him... The unreasonable man adapts surrounding conditions to himself... All progress depends on the unreasonable man." George Bernard Shaw
 
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--2 words: ka. ching. :) if i was your partner and wanted to increase my salary by 25%?! nooice! sure its more work...but its a nice reward too
This would be a big selling point. If we assume 200k/year (though with a 4 person practice I would expect more since less percentage of overhead), the 4 months of deployment would take my monthly gross from 16.6k to 22.2k. It would be a little more work, but for a defined time period and c'mon, if we didn't want to work hard we sure as heck wouldn't have gone into medicine.
 
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Hi VA - you're right again! I'm the sole owner of my practice, so i take a little off the top of my docs. If a 4 doctor group was equally vested in the practice (overhead and income would evenly distributed) then base salary would be closer to $250/doc.

rough math: avg $50/pt/mo x 600 pts = 30k/mo = 360k/yr - 30% overhead = 240 give or take. Lower overhead with a group is very easy. Looking at about 2500 sqft and 2 staff (RNs preferably). Still leaves about 400k in overhead for 4 docs.
 
Hi VA - you're right again! I'm the sole owner of my practice, so i take a little off the top of my docs. If a 4 doctor group was equally vested in the practice (overhead and income would evenly distributed) then base salary would be closer to $250/doc.

rough math: avg $50/pt/mo x 600 pts = 30k/mo = 360k/yr - 30% overhead = 240 give or take. Lower overhead with a group is very easy. Looking at about 2500 sqft and 2 staff (RNs preferably). Still leaves about 400k in overhead for 4 docs.
Down the road I had planned to ask you whether you were sole owner or if the other guys were partners, so I guess that answers that.
 
you can still ask when you're down the road :) but take the one less traveled.
 
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