Should You Offer One-Off Visits?

This question comes up a ton - should you offer one-off visits to those patients interested in an urgent care-type relationship with your clinic?

Here’s a question I came across recently:

So, I'm stepping up to the edge of the pool getting ready to take the plunge, but still struggling with the details.

As has probably gone through the head of virtually everyone who has gone DPC, I'm not sure how well it work in my community.  That said, I'm about to give it a shot and see how it goes.

One thing I've contemplated is whether or not to offer "A la carte" type pricing for people who don't want to actually purchase a monthly membership.  When I've mentioned this to folks doing DPC, I mostly get the advice of "Don't do it.  Too much headache."

I've been warned that it will attract drug-seekers and otherwise annoying/abusive patients.  I've also been warned that it will result in patients expecting to then have the same level of access monthly paying members..i.e. calling for refills, follow up questions, etc. without wanting to pay, making accusations of abandonment if you don't play along, etc.

My biggest worry is that with this option available there may be patients who would otherwise be willing to pay a monthly membership but choose not to due to the al la carte "fee for service" availability.

That said, I feel like I could offer "one off" clinic visits for say $120 or so and still be the cheapest option in my area for people who only go to the doctor when they are sick and thus wouldn't want to join a DPC.  Hard to imagine turning this money away.

Thought I'd through this out to the group and get input on this from folks who have maybe gone down this path previously.

Here’s my response:

At Plum Health, we really try to avoid any one-off type arrangements. When I do offer one-off visits, I charge $200 per visit if they are walking in off the street. For context, our membership is $49/month for adults 18 - 40 years of age. We charge a high rate for the one-off visits so that we don't cheapen the value of the membership for our existing, loyal customers. 

Additionally, if the patient is paying $200 for a visit, why not enroll in the membership for $49 per month? That would give you at least 4 months of great service for the same price. We want to funnel prospective patients into the membership.

I talk about this topic in great detail, as well as many other topics in my most recent book, found here: https://www.startupdpc.com/books

Best of luck!

- Paul 
--
Paul Thomas, MD

Physician with Plum Health DPC

http://www.plumhealthdpc.com/

Finally, we’ve been getting some great feedback from our book, Startup DPC: How to Start and Grow Your Direct Primary Care Practice. Thanks for all the shout outs and support!

-Dr. Paul Thomas with Startup DPC