My Latest DPC Book: Patient Churn (Turnover)

This is basically a sequel to my first book. Direct Primary Care is a life saver for many of us doctors but that doesn’t mean it’s all rainbows and lollipops. Patients joining your dream practice is exhilarating and affirming but patients leaving your dream practice is demoralizing and depressing. And we all go through both. I spent the last year trying to look at what other industries are doing about this and then experimenting with it in my own DPC practice. I think I have some pretty good stuff here that may help everyone at EVERY level, even those just starting out.

Everyone needs to worry about losing patients. It’s not only a blow to your ego when people are going out the door seemingly as fast as they are coming in but also a blow to your bottom line. And it could put you out of business. This books shows you how to do those things that slow patients from leaving. The reason this is important is that once they leave they are probably gone forever. In fact, this book will show you to never argue with anyone going out the door. It will show you the right way to ask “why” they left. This book will talk about value, subscription fatigue, building trust, and doing the little things and the extra touches that may save you a lot of money and heartache in the long run.

Some of the things you will learn by reading Slowing the Churn in Direct Primary Care (While Also Keeping Your Sanity):

  • How and why to analyze why patients are churning through your practice
  • Why some patients are not for you
  • Why hedonistic adaptation is affecting your practice
  • The traps of email and texting
  • How to create a community around your practice
  • The four agreements of DPC
  • You are not an imposter

You can get the book on Amazon now!

Please, please, please leave a review after you read it.

Thank you all.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “My Latest DPC Book: Patient Churn (Turnover)

  1. Bridget Reidy
    August 3, 2019 at 9:36 am

    Wow, can’t wait to read! Do you know if they are leaving for other DPC’s or abandoning the model? But it shouldn’t be surprising, every year there’s more people suffering from the dunning kruger effect, and they can seem really nice and respectful at first. I have the opposite problem here in Canada. There’s such a shortage of FP’s that they stay even if it’s a bad fit. Sometimes you don’t know how vehemently they disagreed with you last year until the next time when they get pissed enough to express it despite their fear of worsening the relationship. In between you wonder why it’s so hard to get a good history.

    • Steve O'
      August 4, 2019 at 9:17 am

      You know, Bridget, the “Dunning Kruger” phenomenon is a result of manipulation of the expectations of individuals, through propaganda or advertising, in their perception of what quality measures might be in a certain area. I wide susceptibility to misinformation due to the dense cultural effects of manipulation throughout the society.
      What I see is much more worrisome than the mistakes of the newcomer. It is the pervasive superstition that one can select one’s own reality through one’s expectations and beliefs.
      We should look carefully at the superstitions and myths of medical care that most non-DPC patients bring in to the DPC encounter. Many people, and especially the corporate and government enforcers as well as patients, are locked into expectations learned in the pediatric examination room.
      One of the big ones, and a money-maker for corporate medicine, is shifting blame onto the patient. “If you were a better person, you wouldn’t be sick.” Both the morbidly obese patient and the physician know that morbid obesity is a drain on the patient’s wellness. Through DPC, one can establish a partnership with a patient that allows the nonjudgmental exploration of problem solving. “You are fat because you suck, and you suck because you are fat. Stop being fat!” cries out for the sales of an anti-fat pill. To talk about human suffering and its manifestation as human obesity is not only more satisfying for the patient and the provider in many instances, but is actually fruitful in weight loss.
      Unfortunately, patients are trained to be as adversarial as possible in all encounters. This leads to the ones who won’t talk, go right to the labs, want an MRI of their pituitary to figure out why they are fat in spite of the stupid doctor. Many of these types are the unfortunates who churn right out of DPC. They won’t face up to the fact that the one person responsible for their misery is the Jerk in the Mirror.
      People imagine that a medical visit is listing their review of snivels, looking in their ears, and saying “Hmm…” over their labs. They have no concept that a medical visit can benefit them; or contrarily, that a medical visit can call majick down upon them.
      Leave the troubled many to the Urgent Cares and the Doc-in-the-Boxes to prescribe a z-pak, some prednisone and an albuterol inhaler for viral rhinitis. That’s what most people seem satisfied with. The few that can understand DPC feel privileged to be your patient, and, that feels kinda cool.

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