Achieving Part-time In Direct Care - The Balance is Real!

The journey in Direct Care is unique to you.  If you're someone who values work-life balance then you've come to the right place.  In Direct Care, you control your model.  With a simple micropractice style model, like I've owned for the last seven years with my partner, you can achieve this balance with a few boundaries and goals in mind.
When you begin your DPC it is key to understand your calculations right off the bat.  How many patients do you need?  The math is simple.  You combine the salary you desire with the hours you'd like to work. 
(1) Estimate your overhead so you can deduct that from your practice income.  
(2) Use your approximate desired salary to calculate the number of patients you need to carry.
(3) Use the patient utilization estimator to determine the number of hours you need to work in the office.
(4) Decide if you plan to have staff to fill in the non-complex patient need hours.  (I have no staff - our office has close to 1000 patients and 3 docs, so I encourage everyone to try it this way and reach out when you're feeling the need to add staff so I can help advise you on how to improve your efficiency and keep it staff-free!).  

​When I use the calculators above, a doctor at our practice requires 27 in office hours per week for 48 weeks per year to meet the demand of his or her 370 patients and come home with $250,000 in annual salary.  At 27 hours per week, that doc is in-house 3 full days or 4-5 part-time days.  I have become accustomed to a 3 day work week and prefer to use 1-2 hours on my "at-home days" to work on remote issues/administrative tasks that come up on those days.  I am able to do the administrative tasks associated with the patients I've seen in the office between visits.  (More on how I structure my day coming in future blogs!).

If you're finding it hard in your existing practice (or in your start-up using the numbers I have provided in the calculators) to make the numbers work with a work-life hours balance, I suggest considering which of the following areas could be adjusted:
- Overhead: how can you cut back ancillary expenses?  Think about what is required for excellent clinical care and access to you as a physician, and see what things are not meeting those aims and could be reduced or eliminated?  Medication inventory may be a good place to consider cutting, especially if it's overwhelming you financially and is time-intensive.
- Income: have you adjusted prices or added a sign-on fee to increase your averages?  Are you being paid well enough to sustain what you're doing?  
- Enjoyment: is it that you're taking on a certain type of patient care that isn't fulfilling or is labor-intensive and could you make any adjustments in your marketing pitch or boundaries to improve this for yourself?
- Find the middle ground: perhaps you can't make it work in under 32 hours, but you also don't need to do 40 hours.  Somewhere in there is the right balance for you - play with what adjustments you can make and find the perfect balancing act.
- Flex scheduling: use your own scheduler (I love the online scheduling features in our EMR) to block time when you start to feel over-worked, to buffer your day with time to complete admin work, and with "personal days" here and there to catch up or take time off!

The goal of Direct Care Lite is to be on a financially and personally better track during your career so that you can comfortably retire when you're eventually ready but you can comfortably enjoy your work and your life now with happiness throughout career.  If you feel stuck or way off track, consider reaching out to me for help on how to make some improvements!

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