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Crafting Healthcare: The Lantern DPC Story (Pt. 1 &2)

Updated: Jun 15

Direct Primary Care Doctor

Dr Aiken in collared shirt.
Dr. Ben Aiken

In the latest episode of the My DPC Story Podcast, Dr. Ben Aiken, who navigated the complexities of the healthcare system in the fee-for-service world, shares about how he left that world unexpectedly and transitioned to his independent DPC, Lantern Health. This blog post delves into the key topics discussed, offering insights into his innovative Direct Primary Care (DPC) approach, the challenges faced, and the vision he has for the future of primary care.

The Genesis of Lantern Health

Dr. Ben Aiken originally worked within the Mission Health system, which was later sold to HCA Healthcare. However, driven by his commitment to collectivism and systemic change, he chose to break away from the traditional path and open Lantern Health. This move was not just about creating another medical practice; it was about foundationally changing how primary care is delivered. Lantern Health was designed to be a beacon, symbolized by its name and circular yellow logo, to illuminate a brighter future in healthcare.


Negotiating Independence and Building a Brand

In a healthcare environment dominated by larger systems, Dr. Aiken faced the challenge of branding and establishing Lantern Health as a separate entity. He kept the project under wraps from other primary care providers and successfully negotiated with the health system to launch independently. This journey required creative thinking and a firm belief in the DPC model as an effective alternative to the standard fee-for-service care that often fails both patients and providers.

Dr. Aiken emphasizes that DPC positions itself positively against the prevalent, often dismal, standard care. Through this model, Lantern Health was able to focus on delivering health, aligning incentives with patient wellness which, as Dr. Aiken notes, is vital for the sustainability and growth of their practice.

Overcoming Financial Risk and Systemic Hurdles

One of the primary challenges Dr. Aiken faced was the financial risk associated with launching an independent practice. Unlike more established models, DPC practices must navigate a path marred by higher overhead costs and longer break-even periods. Dr. Aiken openly discussed that the practice was closed at the two-year mark by the health system, despite requiring about three years to break even. The entry of larger players into the primary care space further underscores the importance of finding a sustainable model that supports systemic change.

Despite these hurdles, Dr. Aiken's focus remained on providing a deeply human experience. Lantern Health leverages technology to offer an authentic experience for patients, and this has been pivotal in maintaining patient trust and continuity of care, even in the face of formidable challenges like the COVID-19 pandemic.

Adaptive Strategies and Resilience

Lantern Health's launch in February 2020 coincided with the onset of the COVID-19 pandemic, which presented unprecedented challenges. Financial and leadership pressures mounted as businesses closed, leading to a significant loss of revenue. Despite these challenges, the practice showed resilience; approximately half of the patients who left during the crisis eventually returned, highlighting the value and trust established by the practice.

Interestingly, about 60% of care at Lantern Health was already virtual pre-COVID, making the transition to predominantly virtual care smoother. This adaptability allowed Lantern Health to continue providing care and even see growth trends throughout the year, despite the broader healthcare upheaval.

An Innovative Approach to Team-Based Care

Dr. Aiken's exposure to international public health and Iora Health's health coach model significantly influenced Lantern Health's staffing approach. The practice includes a blend of roles such as doctors, medical assistants, triage nurses, and health coaches, each contributing to a holistic care delivery system. For instance, each location operates with around three doctors and additional supporting staff, enabling flexibility and preventing burnout.

This collaborative approach not only ensures comprehensive care but also appeals to physicians interested in practicing primary care differently. Dr. Aiken's strategic recruitment, bolstered by his residency training and networking, highlights the importance of community involvement and presence in sustaining a DPC model.

Opportunities for Systemic Change

As the healthcare landscape evolves, Dr. Aiken sees significant opportunities for systemic change in primary care over the next 5-10 years. The reward lies in aligning incentives to improve overall patient health, reducing the transactional nature of traditional care. By focusing on collective community well-being and leveraging models like DPC, practices like Lantern Health can pave the way for a brighter future in healthcare.

Expanding a Vision: From One Clinic to Multiple Locations

In Part 2 of the "My DPC Story" podcast episode featuring Dr. Ben Aiken, listeners are given a deep dive into the challenges and success stories of setting up multiple clinics under the Direct Primary Care (DPC) model. Dr. Aiken shares invaluable lessons from his journey, emphasizing the importance of community connection, flexibility within the team, and scaling the DPC model effectively. Below, we explore the key themes discussed in this enlightening episode.

Building a Trust-Based Team

One of the cornerstones of Dr. Aiken's approach to managing two clinics is the adoption of an independent adult worker model. This model relies heavily on flexibility and trust, where team members are empowered to make decisions and manage their own schedules within the framework of their roles. A team handbook serves as a foundational document, capturing the principles, expectations, and operational guidelines for the team.

Dr. Aiken elaborates on how this approach fosters autonomy and accountability among team members, driving engagement and satisfaction. He underscores the importance of creating an environment where team members feel trusted and valued, which in turn enhances performance and patient care.

Expansion and Hyperlocal Connections

As the practice considers expanding to a third location, Dr. Aiken emphasizes the need to maintain the brand's core identity while fostering hyperlocal connections. This approach ensures that each clinic resonates with the unique needs and characteristics of its community. Dr. Aiken's original vision of scaling the DPC model to the entire health system inspires the decision to open additional clinics, driven by the belief that relationship-driven care can significantly impact healthcare outcomes.

An interesting catalyst for the second clinic was the availability of a space previously occupied by a retiring OBGYN. Seizing this opportunity highlighted the readiness and agility required to expand successfully.

Advocacy and Legislative Engagement

A significant portion of the episode is dedicated to the advocacy work done by Dr. Concepcion and Dr. Aiken. They recount their recent trip to Washington, DC, where they joined other independent DPC doctors, Amazon and Boeing lobbyists, and DPC movement representatives to lobby for two important bills. A highlight from this effort is the Medicaid Improvement Act, which passed the House floor unanimously and with bipartisan support.

The Medicaid Improvement Act empowers states to offer direct primary care to Medicaid recipients without federal restrictions, giving forward-thinking states the flexibility to pilot DPC programs. Dr. Aiken emphasizes the importance of having DPC physicians involved in legislative decisions to maintain alignment with the core principles of DPC and avoid the pitfalls of fee-for-service models.

Dr. Bliss, another advocate, dispels the myth that mentioning Medicaid would revert DPC to a fee-for-service model, highlighting the importance of DPC's presence in legislative conversations. The Act also calls for virtual open-door meetings to gather input from stakeholders, providing a platform for DPC voices to be heard.

Challenges and Opportunities with Employer-Sponsored Care

Dr. Aiken discusses the complexities of working with employer-sponsored care, noting that over 50% of Americans receive healthcare through their employers. Engaging with employers presents unique challenges, such as low employee engagement and high turnover rates in certain industries. Dr. Aiken emphasizes the need to align with employer expectations and demonstrate the value of DPC through patient engagement and satisfaction metrics.

Working with employers involves navigating relationships with brokers, which can be both an opportunity and a challenge. Dr. Aiken advises authenticity and caution in broker partnerships, promoting direct communication with business decision-makers to ensure alignment and mitigate potential issues.


Entrepreneurial Risks and Rewards

The journey of expanding a DPC practice is not without risks. Dr. Aiken shares his experiences of taking entrepreneurial risks, such as signing a lease before hiring a team. He emphasizes the importance of being comfortable with uncertainty and the willingness to take calculated risks for the greater goal of expanding access to relationship-driven primary care.

Dr. Aiken’s practice serves various employer groups, from small businesses to large companies with over 500 employees. Each scenario presents a learning opportunity and adds to the complexity of managing different health plans and expectations.

The Power of Storytelling

Dr. Aiken highlights the power of storytelling in conveying the principles and benefits of direct primary care. By sharing real-life experiences and outcomes, DPC advocates can create a "stickiness factor" that resonates with both patients and stakeholders.

In conclusion, Dr. Concepcion encourages listeners to stay informed, stay healthy, and advocate for the DPC model. The "My DPC Story" podcast continues to serve as an invaluable resource for anyone interested in diving deeper into the direct primary care movement. Whether through legislative advocacy, building resilient teams, or navigating employer partnerships, Dr. Ben Aiken and Dr. Maryal Concepcion's insights provide a roadmap for those passionate about transforming primary care.


Patient-Centered Survey (as heard on Dr. Allison Edwards' My DPC Story pod interview)

Medicaid Improvement Act:

Join in on lobbying and tell your stories Sept 9-10th, 2024:

WATCH HERE (Parts 1&2):

LISTEN HERE (Parts 1 & 2):

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