Should I offer a waitlist for my DPC practice?

A primary benefit and one of the more enticing features of the direct primary care (DPC) practice, for both the provider and the patient, is a smaller patient panel. Rather than trying to care for several thousand patients, the DPC physician typically has a patient panel of several hundred. This enables the provider to develop a helpful relationship with the patient and enables the patient to receive more personal attention as well as higher quality care.

Once the DPC practice’s goal has been reached in terms of the number of memberships, the physician may be wondering whether it’s a good idea to develop a waitlist. Although the number of DPC practices is growing in the US, the number of providers who have achieved their ideal panel size is still small.

The American Academy of Family Physicians (AAFP) estimates that the average DPC panel size is 345 patients. The average target panel size is 596 patients. In 2018, AAFP reported that 17 percent of DPC practices had reached their ideal panel size.

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One of the reasons for maintaining a smaller, more manageable patient panel is also one of the tenets of the DPC model, as detailed by the Direct Primary Care Coalition (DPCC). As the Coalition explains, advocacy is an important principle. DPC providers are committed advocates for patients within the healthcare system.

Due to their patient panel size, DPC physicians have time to make informed, appropriate referrals and support patient needs when they are outside of primary care. DPC providers accept the responsibility to be available to patients serving as patient guides. No matter where patients are in the system, physicians provide them with information about the quality, cost, and patient experience of care.

However, the time may come when the DPC provider reaches that target patient panel size and must make a decision as to whether to offer a waitlist when additional patients want to join. Although the DPC structure is obviously different and the waitlist would be for membership rather than for an appointment, a recent MGMA STAT poll provides some insight into the thinking across the majority of healthcare organizations.

According to that poll, a majority of healthcare organizations use patient waitlists to fill open appointments. The poll was conducted on June 19, with 1,347 total responses and asked healthcare leaders if their organization uses a patient wait list to fill next-available appointments as they open up. Responses showed that:

  • 61 percent did use a patient waitlist
  • 7 percent were considering it
  • 29 percent did not offer a patient waitlist
  • 3 percent weren’t sure. 

Many of those who said their organizations used a wait list said it was actually part of their electronic health record (EHR).

The poll results are significant in that they emphasize the importance of providing an opportunity for patients to access healthcare. A waitlist can also help the DPC practice ensure a continuing influx of new members. If the DPC physician decides that the practice should not accept new patients after the ideal patient panel has been reached, it can negatively affect the image of the practice. Offering a waitlist reassures patients that the DPC practice is thriving and will continue to grow and be successful, adding new members as space becomes available.