Detroit-area DPC Workshop Provides Insight, Innovative Ideas


“I was really intrigued with the wide variety of opportunities within the Direct Primary Care model, whether it is a transition from a traditional practice, a hybrid, or an entirely new start-up,” said MAFP Board Member Mary Marshall, MD, RN (Grand Blanc), after attending the AAFP-sponsored Direct Primary Care (DPC) Workshop on April 2 at the Marriott Detroit Metro Airport.

Dr. Marshall was one of over 40 participants, including MAFP Advocacy Chair Loretta Leja, MD (Cheboygan) and MAFP CEO Debra McGuire, who gained an in-depth understanding of transitioning to a DPC practice during the one-day, peer-to-peer session.

Along with delving into the broad capabilities and various structures of DPC practice models, speakers W. Ryan Neuhofel, DO, MPH and Attorney James Eischen, Jr. helped Family Physicians understand the regulatory and legal aspects related to establishing a DPC practice. The two keynoters identified the main factors involved in establishing a DPC practice, including specific examples that Dr. Neuhofel cited from his own practice in Lawrence, Kansas. Being able to articulate your specific vision, mission and philosophy are key to shaping your DPC business plan, according to Dr. Neuhofel, as are the financial aspects. Through some trial and error, Dr. Neuhofel says that he now operates a profitable practice with a patient panel size that is manageable between himself and one nurse that he employs. According to Dr. Neuhofel, the panel size of most DPC physicians is between 300-600.

Eischen, a partner at Higgs Fletcher & Mack LLP in San Diego, provided additional insight relative to physician-patient agreements, HIPAA compliance and other legal aspects to address during a transition to DPC. Attendees also learned more about the pros and cons of Medicare participation in a DPC practice, as well as the expectations that patients have for their DPC physician and community healthcare providers. A toolkit—which outlined federal and state regulations to consider, as well as business strategies, checklists and financial worksheets—was provided to each participant.

To support DPC and other new models of care, Eischen emphasized the importance of becoming involved in advocacy efforts. Michigan Senator Patrick Colbeck (from District 7, which encompasses areas in Southeast Michigan) was in attendance and spoke about the need to contain spiraling healthcare costs. He is currently  working on a proposal for a pilot to study ways to expand Direct Primary Care access for the Michigan Medicaid population.

“I hope that MAFP members who are seeking a way to deliver healthcare in a manner that is more fulfilling to them, will look into the DPC model to see if it could work for them and their patients,” Dr. Marshall said.

For more about the workshop, see the upcoming summer issue of Michigan Family Physician. MAFP members considering transitioning to a DPC practice are encouraged to contact a healthcare consultant and/or attorney familiar with DPC models of care, or may email AAFP ( for additional information and assistance.

Pictured above (L-R): Senator Patrick Colbeck (R-Canton); Loretta Leja, MD (Cheboygan); and Mary Marshall, MD, RN (Grand Blanc).