Staffing Your Direct Care Clinic

How many staff members do I need for a Direct Care practice?

Congratulations if you’ve popped the cork on your “cash-only” Direct Care practice! From the outset, you are the captain of your practice, and the sole reason that it even exists. But we’ve got another question to ask before we get to staff…

Do you have the support of your spouse?
The Concierge Medicine Research Collective found in April 2013 that changing your business model to one that’s concierge or fee-for-care is most successful at 18 months in the joint agreement of both spouses, whether they work together or not. That said, most concierge doctors and Direct Care physicians should look to grow their practice after the second or third year. The first year should be dedicated to handling your first wave of patients and ironing out any kinks in your workflow. Figure out your local pricing model locally and make any necessary adjustments to achieve a reasonable profit margin. Research suggests that success hits fast around the 18-month mark, and that’s when staff will come into play.

As of 2013, about 62% of concierge medicine practices and Direct Care clinics employ one to two people. When done correctly, your practice should need minimal staff. Assuming you and your doctors are willing to reproduce our lean processes such as all doctors answering phones, scheduling their own patients, rooming patients themselves and counting pills (using a HISPAC III pill counter, of course) etc.

Of course we’re a quality over quantity type of business. But we think you can find a happy medium between the two, and find yourself in a profitable position in a reasonable amount of time.


Keep in mind, the average family medicine practice keeps seven to 10 employees on staff per physician. Currently it’s amazing. We’re averaging one employee for our three physicians (God bless you, Jeannie!). However, one employee per physician would still be a great, and seriously profitable, ratio.

We’re not about withholding secrets here at Atlas. You should know that the reason we’re able to keep staff ratio so low is because of an EMR application we designed ourselves, exactly for our type of Direct Care medicine.

It’s called and you can check it out for a free trial month. It’s valuable whether you have or haven’t started your own practice. For one, if you are practicing, it will make your life easier. And if you’re looking for more reasons to transition into this emerging field, the EMR will help you make it happen.

What's next?

Congratulations! You’ve reached the end of the curriculum. A final note of encouragement and reassurance is right around the corner.