14. Panel size and time
Cash-pay founders Planned episode, the cash-pay practice. How many patients a relationship-based practice can carry well.
Listener title: Panel size and time in a relationship-based practice
Listener description: A direct primary care physician talks about how many patients a relationship-based practice can carry well: how they chose a panel size, the signs it has grown too large, and what more time per patient changes in the care. For cash-pay founders setting or revisiting a panel. The guest describes their own reasoning, not a recommended number.
Run of show (about 40 minutes)
| Time | Segment | What happens |
|---|---|---|
| 0:00 to 2:00 | Opening | Host introduces the topic and the guest. The guest discloses any industry relationships. Host notes that guests speak for themselves and that cases come up only as problems, without the patient. |
| 2:00 to 12:00 | Choosing a panel size | How did the guest choose their panel size? What did they weigh: visit length, expected visits per patient, how patients reach them between visits, their own clinical hours? The guest explains their reasoning rather than offering a number for others. Host notes the related check on the network's pricing page: expected visits per patient against clinical hours. |
| 12:00 to 20:00 | Signs it has grown too large | What are the signs that a panel has grown too large? Which did the guest notice first: access, messages, follow-up slipping, their own fatigue? Which would they watch for from the start? |
| 20:00 to 26:00 | When the signs appear | What did the guest do when they saw those signs: close the panel, keep a waitlist, change how patients reach them, or something else? How did they explain the change to patients? |
| 26:00 to 36:00 | What more time changes | How does more time per patient change the care? Where does the time go: the history, the family history, coordination with other clinicians, reading between visits? What does the guest do now that they could not do before? |
| 36:00 to 40:00 | Closing | One practical takeaway: decide in advance which signs you will watch for and what you will do when you see them. To reach the network, email hello@coloradocarenetwork.com with a topic in two sentences; physicians and APPs can express interest on the Join page, coloradocarenetwork.com/join/; members can post in #podcast on Slack. |
Guest prep questions (sent to the guest a week ahead)
- How did you choose your panel size, and what did you weigh? We are interested in your reasoning; please don't present a number as a recommendation for others.
- How do you check that expected visits per patient fit within your clinical hours, and how often do you check?
- What were the first signs, for you, that the panel was getting too large? Which would you watch for from the start if you were beginning again?
- When you saw those signs, what did you do, and how did you explain it to patients?
- How has more time per patient changed the care you give? Please keep examples to the clinical problem, without details that could identify a patient.
Show notes
A direct primary care physician describes how they chose a panel size, the signs that a panel has grown too large, and what they did when they saw them. The second half is about what more time per patient changes in the care, with cases discussed only as problems. The guest speaks from their own practice, and no panel size is offered as a standard.
- Sources and tools:
- Setting a cash price, https://coloradocarenetwork.com/practice/pricing/ : "Membership fee. If you run a panel, the panel size times the fee has to cover the annual cost; check the expected visits per patient against your clinical hours."
- No patient information is discussed on this episode.
All planned episodes. To be the guest for this episode, email hello@coloradocarenetwork.com with the episode number.