On DPC & Community: A Conversation with Brian Forrest

When Dr. Brian Forrest set out to open Access Healthcare nearly fifteen years ago, the Direct Primary Care community did not yet exist. At the time, the model lacked name recognition, institutional backing, legal expertise, and a standardized set of best practices from which practitioners could draw support. After deciding he could no longer work under a failing healthcare system, Dr. Forrest had no choice but to build his direct pay/retainer-based practice almost entirely on his own. Now, as he runs his thriving business alongside his five colleagues in Apex, North Carolina, Dr. Forrest seeks to share one piece of advice to doctors considering switching to DPC in 2016: “Don’t go it alone.”

As Dr. Forrest points out, the steady increase in popularity of DPC over the past decade has led to the creation of conferences, workshops, tools, and technology all designed to facilitate an easier transition out of the traditional medical model. Established practitioners often serve as mentors to new DPC doctors in their area and legal experts tend to be much more versed in the ways that regulation limits alternative ways of providing care. “If I had these resources available to me fifteen years ago, my journey would have been easier, swifter, and certainly less exhausting. I learned through constant trial and error; doctors today don’t have to. I think as more people start recognizing the potential of DPC, it will become more feasible for practitioners to join the movement—and that’s a wonderful change to witness.”

Seek Out Mentors

Dr. Forrest finds it rewarding share his experiences and expertise with others. He notes that his attitude is typical of most established practitioners, and describes the larger DPC community with this metaphor: “It’s almost as if those of us who have converted to the model are riding across the ocean on a cruise ship, and when we look out at the horizon, we see other physicians trying to stay afloat in shark-infested waters. I think everyone desperately wants to throw those folks a life raft. We want to get them out of an ultimately unlivable situation and onto the cruise ship with the rest of us.”

Dr. Forrest encourages doctors transitioning to Direct Primary Care to take advantage of all available lifelines and resist the temptation of just swimming to the cruise ship on their own. “I firmly believe that DPC docs want to help other physicians, so I always recommend that people reach out to more knowledgeable practitioners for advice, support, and inspiration. This movement depends on collectivity, and I think budding DPC practices may struggle in isolation.”

Find Your Network

If Direct Primary Care doctors had been pooling their resources, mentoring one another, and sharing access to regional and national employers back in 2001, Dr. Forrest is certain his practice would have grown at a much faster pace. “When I started out, we literally didn’t have a single patient. We open our doors on a Monday, and our first patient didn’t walk in until Thursday.”

Having access to a community of DPC experts would have provided Dr. Forrest with invaluable insights—particularly in respect to effective messaging. “I didn’t know how to clearly assert the value of this new model to potential patients. Direct Primary Care is unique. Patients get what they pay for. Unlike under co-pay culture, patients are actually paying the doctors to work for them—not the insurance company. That difference is often not readily recognizable to those who have received care from the traditional healthcare system their entire lives.”  

Dr. Forrest has learned about the importance of DPC networks through his own active participation. “They provide connections to the business community, access to best marketing practices, a sense of how to price services, and a template for a standard membership agreement. Our network also has two lawyers who give us advice about what should be in our member practices’ contracts, what we should and shouldn’t say to patients about filing insurance, and what is and isn’t legal in various states. I really can’t overstate the benefits of this kind of information. Having ongoing access to a network allows DPC docs to ask questions to those who have been on this journey for a long time.”

Band Together

The growth in popularity of Direct Primary Care has made the model more financially feasible for practitioners in several ways. The increased awareness about DPC has allowed practitioners more access to bigger businesses’ employee populations and better patient understanding of the value of memberships. Dr. Forrest also points out another effective way to take advantage of the expansion of the DPC community: group purchasing.

“Physicians working under the DPC model need similar supplies, and they all also need to keep their overhead low. Group purchasing makes both possible.” Dr. Forrest notes that a number of group purchasing networks have grown directly out of the Direct Primary Care movement, allowing doctors to get the necessities at a lower cost.

Along with making essential supplies more affordable, increased visibility of the DPC model has compelled some malpractice companies to offer inexpensive insurance to private practitioners. Dr. Forrest suggests that DPC doctors explain to in-state providers that they’re seeing a lower volume of patients per day, decreasing their risk exposure. “Very often we can get 25%-60% off of standard malpractice rates. Sizeable discounts like these indicate that our community is instigating change, and other industries are taking notice. It’s remarkable to see how far we’ve come. I’m certain new DPC providers will be able to take us even further.”