Why more DPC practices on the map in some areas than others?


(cjs56) #1

If you look at the Frontier web site, you will see many D.P.C. practices in North Carolina. Then, look at Southern California.
I am wondering why so many D.P.C. practices in North Carolina and not so many in Southern CA.
Does anyone know why?
Could it be:

  1. that the residency programs in N.C. are marketing D.P.C. better than other states?
  2. that office space is very expensive in CA?
  3. that there has been a D.P.C. spokesperson (physician) in N.C. like Dr. Forrest?
  4. that there are too many large corporations for so many years in So. Cal. like Kaiser, Sharp, Scripps, etc. that the consumers are so familiar with these entities and also have received good care from them. Why switch to something if it has worked so well for so many years?
  5. that, other than University and Hospital systems, there are much less large organizations in N.C. to compete with?
  6. that the cost of living in CA is so high to begin with that any “disposable income” for a new resident or a physician is not going to go to opening a D.P.C.?
  7. that there is minimal market for a D.P.C. because the wealthy already have their insurance, can afford it, are satisfied with it and feel no real need to change?
  8. that the poor are on CA Medicaid (Medical) and could never afford $50.00 per month for a D.P.C. practice?
  9. that there is not much middle class income in CA?
    Anybody know why not as many D.P.C. practices in CA as other states?

(Robin Dickinson) #2

I think there are a lot of reasons why one area may have more DPC than another. I’ve heard that here in Colorado we have the most and most of us built up separately from one another, a lot in 2012-2013 without knowing of each other’s existence until recently. So I don’t think DPC spokepeople or marketing are the reason.

I do think Kaiser etc may be part of it. My aunt is from California and she and everyone she knows have always had Kaiser and she had trouble understanding the need for DPC. Here in Colorado, people generally look down on Kaiser (though I personally go there and have received really excellent care).

I don’t think Medical has much to do with it on its own because here in Colorado we have Medicaid expansion too and I still have tons of patients who make too much for Medicaid and too little for “real” insurance. But if there are a large number of people who qualify for Medical and a large number of people who can afford good insurance and not many people in the middle, that could be part of it.

Overhead may be part of it as well. My uncle makes really good money and his neighborhood looks like the poor neighborhoods here. I could afford to buy a house in Colorado only a couple years after my aunt did in California. I mentored a physician who opened in a different part of California and her overhead for the same style of practice as mine is twice mine, which means she has to charge twice a much, which means she has to find patients who can pay twice as much.

I’m curious other people’s thoughts. @forestdpc maybe you have some other thoughts?

(Robin Dickinson) #3

@jamesgaor You’re in the same area…what do you think are some of the reasons?

(cjs56) #4

thanks. got. it.

I am going to continue to look for answers.

talk to more people.

meet more people.

But, I think I already know.

As my mother used to say…the rich get richer.

And my father used to say…If you are poor in the Dominican Republic…then you’re really poor.

(Douglas Farrago) #5

I think all your thoughts were spot on. We are in the “wild west” of DPC. No one knows all the answers but once it hits a tipping point then watch out. I mean, what family doc wouldn’t want to make the same or more money than the employed doc and see less patients and have control over your destiny?

(Dr Brian Pierce) #6

Small populations in studies are more susceptible to random variations. The population of DPC docs is still very small so some random variation in distribution of DPCs is not surprising. That won’t be the case in 10 years when there are many more of us.

(James Gaor) #7

I think you make a lot of valid points about the relatively small amount of DPC practices in SoCal. There is a different culture here which is that it is HMO dominant and people have an expectation that insurance covers their health care, whether if with PPO or HMO insurance. Concierge has been around here for a long time, but that carries a stigma of “rich people” healthcare.

The Kaiser/Sharp/Providence/Dignity health systems and HMOs will dominate this market for quite awhile but there is plenty of people who are looking for a “different” healthcare experience. DPC will continue to be a niche market here for awhile but there is plenty of opportunity to creat a “successful” DPC practice in SoCal.