How long does it take to start a DPC practice?

Most physicians take three to six months from decision to opening, though some move faster and others take up to a year. The legal and compliance work (entity formation, Medicare opt-out, membership agreement) is usually the longest pole, so start it first. Software and workflow setup can be done in days near the end.

What is the first thing to do when starting a DPC?

Get clear on your model and your ideal patient, then start the legal setup immediately, since it takes the longest. Form your business entity, check your state's DPC statute, and decide whether you are opting out of Medicare. These decisions shape everything else.

Do I need an LLC to start a DPC practice?

Most DPC doctors form an LLC or professional corporation so the practice, rather than the individual, carries liability for debts and lawsuits. The right entity type depends on your state, so confirm with an attorney or accountant familiar with medical practices.

Should I hire staff before opening my DPC?

Many DPC doctors open solo and add help only once their panel grows. When they do hire, the first role is often an office manager or medical assistant who handles administrative work. You can launch lean and grow into staff as membership revenue supports it.

The DPC Startup Checklist: Your First 90 Days, Step by Step

A Plan You Can Actually Work, One Box at a Time

The thing that stalls most aspiring DPC doctors is not a hard step. It is the feeling of facing all the steps at once. Legal, financial, clinical, technical, all blurring into one overwhelming "someday."

The fix is a sequence. Most practices go from decision to open doors in three to six months, and the work falls into a natural order: the slow legal pieces first, the build in the middle, the launch at the end. Below is that sequence as a 90-day checklist. Treat it like a board of tasks and just keep moving the next one. If you want the why behind each phase, read the full how to start a DPC practice guide alongside it.

Before the Clock Starts: Get Your Decisions Straight

A few choices shape everything downstream. Make them first.

Define your ideal patient and the community you want to serve
Choose pure vs. hybrid (memberships only, or memberships plus some insurance)
Decide whether you will opt out of Medicare
Set a rough membership price and the panel size you would need to break even
Pick a practice name that is easy to say, spell, and remember

Days 1 to 30: The Legal and Financial Foundation

This phase takes the longest to clear, which is exactly why it goes first. Start it on day one and let it run in the background while you do everything else.

Form your business entity (usually an LLC or PC)
Check your state's DPC statute so your membership is not regulated as insurance. DPC Frontier has a state-by-state map
Engage a health attorney familiar with DPC to draft or review your membership agreement
File your Medicare opt-out affidavit if applicable (remember: opt-out is effectively permanent since 2015)
Get malpractice insurance (often cheaper for DPC thanks to small panels and low volume)
Open a business bank account and set up basic bookkeeping
Compile your HIPAA forms and check whether CLIA and OSHA apply to your setup
Set your startup budget using our DPC cost breakdown

Days 31 to 60: Build the Practice

With the legal machinery turning, build the thing patients will actually experience.

Lock in your space: home visits, a rented room, or a small office, matched to your budget
Choose your EHR with membership billing. Compare options in the best EHR for DPC clinics guide
Set up your software stack: messaging, labs, e-prescribing, and an AI scribe. The full list is in what software you need to start a DPC
Connect your tools onto one screen with a workflow layer so your day is not eight browser tabs. Tabflows has a free tier and a setup guide that takes minutes
Finalize membership pricing and tiers (flat rate, age tiers, family plans, annual prepay)
Build a simple website that explains what membership costs and how to join
Order supplies and any equipment your model needs

Days 61 to 90: Launch and Fill Your Panel

Now you turn it on and get your first members.

Set up your enrollment and payment flow so signing up is effortless
Design your daily workflow before patient one: where messages get triaged, how refills and labs and follow-ups stay visibly owned so nothing falls through the cracks
Tell your network. Your first 50 patients come from people who already trust you
Reach out to local employers who might enroll a whole team at once
Build community presence: local talks, press, and word of mouth
Open your doors and see your first patient
Decide your first hire trigger: the panel size at which you bring on an office manager or MA

The Mindset That Carries You Through

You will not finish every box in exactly 90 days, and that is fine. Some legal steps run long, some patients arrive early. The point of the checklist is not a perfect schedule. It is that you always know the next thing to do, which is the difference between a practice that opens and a dream that stays a someday.

Build the system before you are busy. A practice of one still needs a workflow, because that workflow is what lets you grow to a practice of three without everything living in your head.

When you are ready to go deeper on any phase, the complete guide to starting a DPC and the software stack breakdown pick up where each checkbox leaves off.

The future of DPC
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