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The Minimum Viable Practice

Quick Summary: This is everything you need to legally see your first DPC patient. Not everything you'll eventually want. Everything you need. Complete this checklist and start.


The Checklist

Legal/Regulatory (Required)

  • Medical license - Current in your state (you have this)
  • DEA registration - $888, apply at deadiversion.usdoj.gov (can delay if not prescribing controlled substances initially)
  • NPI number - Free, you have this or get at nppes.cms.hhs.gov
  • Business entity - LLC preferred, $50-500 depending on state
  • EIN - Free, IRS.gov, takes 5 minutes
  • Business bank account - Free, any bank

Time: 1-2 weeks | Cost: ~$500-1,500

Insurance (Required)

  • Malpractice insurance - Contact broker, mention DPC for lower rates
  • Expect: $200-400/month for family medicine
  • Get quotes from: TMLT, The Doctors Company, ProAssurance, state medical society

Time: 1 week | Cost: ~$200-400/month

Patient Care (Minimum)

  • Stethoscope - You own one
  • Blood pressure cuff - $25-50
  • Thermometer - $10-20
  • Pulse oximeter - $20-30
  • Otoscope - $50-200 (basic is fine)
  • Scale - $25-50
  • Penlight - $5-10

Time: Amazon Prime | Cost: ~$150-350

Communication (Free/Cheap)

  • Phone number - Google Voice (free) or your cell
  • Secure messaging - Signal app (free, HIPAA-appropriate)
  • Email - Gmail or professional domain ($0-6/month)
  • Video visits - Doxy.me free tier

Time: 1 hour | Cost: $0-6/month

Documentation (Free)

  • Patient records - Choose one:
  • Paper charts (legal, $0)
  • Google Docs with Workspace BAA ($6/month)
  • Practice Fusion free tier ($0)
  • Membership agreement - Word document (template in this kit)
  • Basic intake form - Word document (template in this kit)

Time: 1 hour | Cost: $0-6/month

Presence (Minimal)

  • Google Business Profile - Free, essential for local search
  • Simple website - Choose one:
  • Carrd.co ($19/year)
  • About.me (free tier)
  • Single page on Squarespace ($16/month)
  • Even just a Google Business Profile works initially

Time: 1-2 hours | Cost: $0-19/year

Space (Flexible)

  • Where to see patients - Choose based on your situation:
  • Home office (if zoning allows)
  • House calls (patient homes)
  • Shared medical space (rent by hour/day)
  • Sublease from another physician
  • Telehealth only (to start)

Time: Varies | Cost: $0-500/month


Total Minimum Investment

Category Upfront Monthly
Legal/Entity $500-1,500 -
DEA $888 -
Equipment $150-350 -
Malpractice - $200-400
Communication - $0-6
Website $0-19 -
Space $0-500 $0-500
TOTAL $1,500-3,250 $200-900

Break-even: 3-10 patients at $100/month


What You're NOT Doing Yet

Save these for when you have revenue:

Item Wait Until
Dedicated office lease 50+ patients
EMR software 30-50 patients or when paper becomes burden
Scheduling software You're actually busy
Staff/MA You can't keep up alone
Fancy website You have money to spend
Point-of-care testing Volume justifies equipment
Marketing spend Word of mouth isn't enough

Speed Run: First Patient in 7 Days

  • File LLC online
  • Apply for EIN (immediate)
  • Apply for DEA (if needed)

Day 3: Insurance

  • Call malpractice broker
  • Get quote, bind coverage

Day 4: Setup

  • Set up Google Voice
  • Download Signal
  • Create Google Doc templates (or grab from this kit)
  • Claim Google Business Profile

Day 5: Presence

  • Create Carrd one-page site
  • Post on personal social media: "I'm starting a DPC practice"

Day 6: Equipment

  • Order basics on Amazon (or use what you have)
  • Set up home office / identify space

Day 7: Launch

  • Tell everyone you know
  • Sign your first patient

The One-Page Practice

Your entire operation can fit on one page:

MY DPC PRACTICE

License: [State] #12345
DEA: [Number]
NPI: [Number]
LLC: [Name], EIN [Number]

Contact:
- Phone: (555) 123-4567 (Google Voice)
- Text: Signal
- Video: doxy.me/drsmith

Schedule: Paper calendar on desk

Records: Google Docs folder / Paper charts

Membership: $100/month, collected via Venmo/Square

Location: Home office / House calls / Telehealth

That's it. That's a medical practice.


Objections Answered

"This seems too simple"

It is simple. Medicine is fundamentally a doctor helping a patient. Everything else is overhead.

"Won't patients expect more?"

Patients expect a good doctor who listens and is available. They don't expect software.

"What about labs?"

Quest and Labcorp have cash-pay options. Set up account when you need it. Patient goes to draw site.

"What about prescriptions?"

E-prescribe through free services (some pharmacies offer this) or paper Rx pads to start.

Yes. Paper charts are legal. Home offices are legal (check zoning). House calls are legal. Phone consultations are legal. DPC without insurance is legal in all 50 states.

"What if I get too many patients?"

That's called success. Add infrastructure when revenue supports it.


Next Steps

After your first patient:

  1. Learn - What do they actually need from you?
  2. Iterate - Adjust your systems
  3. Grow - Tell more people
  4. Add - Infrastructure when necessary

Don't add before necessary.



[!NOTE] This is the minimum to start, not the minimum forever. Your practice will grow and professionalize naturally. The point is to start.


A practice with one patient is infinitely more real than a business plan with none. Start.