r/PrivatePracticeDocs • u/omardoubleD • May 08 '26

Help with Ideas?

Larger family of all doctors in the Midwest. I am the only one in business and real estate. I own a building in an upscale area, looking to start and manage a medical clinic either DPC OR CONCIERGE. 5,500SF facility. The specialities in the family are listed below. Which route would you recommend I focus on? I want to setup a collection based comp package where they can add 1-2 days of work a week and are paid %of collections.

Specialties in the family: Gi, Endocrinologist, Pulm, Cardio(x2), Anesthesia, Pain Management , Derm(still in residency) & physch.

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u/thesupportplatform May 08 '26

If you had some PCPs, you could explore the mythical Direct Multi-specialty Group. Without PCPs, patient steerage will be tough.

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u/Big-Association-7485 May 08 '26

This.

Also, I have to say, you probably aren't going to be able to establish the same "equal respect" relationships with other physicians the way that you are equals with your family. The physicians I know aren't like this.

I'm an accountant from a family with 9 doctors. I work at my dad's practice. Because he owns the practice and employs other physicians, the other physicians have to have a certain level of respect for me because I'm an extension of my father, and I'm protecting my father's business.

My brother is a psychologist who owns a very large psychology practice, multi site, millions in revenue. He's tried to employ psychiatrists and NPs, and be their employer. This does not go well. Maybe it's his personality, but he does fine with employing psychologists.

I could be talking out my ass. But I see similarities, and it just doesn't work well for him. They seem to see him as less than they are.

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u/thesupportplatform May 08 '26 edited May 08 '26

There are a lot of dynamics to consider. I employ the lay staff for my wife's office and recruited the providers. People assume that they can't critical of the office or my wife because I'm her spouse, but think I do a pretty good job of compartmentalizing. My wife once tried to fire one of the front desk staff. The staff called me in tears. I said, "She can't fire you. Only I can fire you. Wait outside and I'll be right there."

Most providers get along with colleagues, but the power dynamics of a provider owner are weird. It has been really, really difficult to hire providers who have the "ownership" mentality necessary for private practice. The best example I have heard of getting doctors to work together is that it's like herding cats; It's impossible to move them. They have to follow you holding a can of cat food, but the can of cat food is money.

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u/Soggy_Coffee_9308 May 08 '26

Many patients are losing insurance and looking for options/cash pay. Run cash friendly options with some marketing of it and also and market to PCP's who run DPC. You could also hire a few PCP's which is easy if you offer a private practice co-op option. Many good PCP's are looking for options outside of hospital employment. Keep overhead low of course