Everything You Need to Know About Hiring a VA and How You Can Find Great Help For a Fraction of the Cost

Maryal Concepcion
7 days ago
6 min read

Justin Lam, CEO and Founder of Cool Blue VA talks about medical virtual assistants in DPC. — Justin Lam, CEO and Founder Cool Blue V

Discover how leveraging virtual assistants can streamline your operations, protect your time, and elevate the patient experience in Direct Primary Care

The DPC Time Dilemma and a Modern Solution

Direct Primary Care (DPC) continues to transform the healthcare landscape, giving physicians and patients a breath of fresh air outside of the insurance-driven status quo. Yet, even in this freeing model, DPC physicians face a universal bottleneck—time. As solo or small-team practitioner-entrepreneurs, DPC doctors balance patient care, documentation, communication, marketing, and a never-ending to-do list.

In a recent episode of My DPC Story Podcast, host Dr. Maryal Concepcion welcomed Justin Lam, founder and CEO of Cool Blue VA, to break down how DPC physicians can strategically leverage medical virtual assistants (VAs) to scale, reclaim their lives, and focus on what matters most: patient care and practice sustainability. If you’re building, growing, or even just dreaming about your DPC practice, this deep dive will help you reflect on your systems, your bottlenecks, and how to set up your practice for long-term satisfaction and success.

The Most Valuable Asset in Your Practice—You

It’s tempting, especially in startup mode, to believe you can (or should) “do it all.” The truth, as Justin Lam emphasizes, is that your most precious, rate-limiting asset is not your EMR, your marketing funnel, or even your patient panel—it’s you, the doctor. Your time, expertise, and well-being drive your DPC’s trajectory.

Studies underscore an ugly truth: Physicians may spend two hours on clerical or EHR work for every hour of face-to-face patient care. Multiply that over the week and you have “pajama time”—late nights spent on charting, emails, refills, and admin. This is time that doesn’t directly serve your patients or your practice, and importantly, it’s time you don’t get paid for in the DPC model.

Key Reflection:Are you spending your limited work hours (and personal hours) on the tasks only you can do, or are you filling the cracks with paperwork and busywork that others could handle?

Is It Time to Hire a Virtual Assistant?—Self-Audit First

Dr. Concepcion and Justin advocate for a two-step self-audit that should become a regular pulse check for every DPC owner.

Exercise 1: Time and Task Audit

List your top five weekly tasks.
Note how much time each takes.
Circle any task you could delegate (i.e., anything not physically requiring your presence).

Typical Delegatable Tasks:

Charting and documentation
Patient communications (calls, texts, portal messages)
Ordering labs, imaging, referrals
Prescription refills
Social media or content scheduling
Insurance verifications (if hybrid)
Bookkeeping or scheduling

Even if you feel you “manage well” now, seeing the tasks in black and white often reveals how quickly they add up and how much of your unique MD skills are absorbed by clerical work.

What if you’re new or in pre-launch?If you haven’t opened yet or have a small patient panel, ask seasoned DPC peers about their top tasks. Also track what drains you the most—sometimes your “least favorite” task is the one you’ll benefit most by delegating.

Beyond Time—Identify Your Skills Gap

It's not just about time saved—it’s also about skill optimization. Most DPC physicians are brilliant clinicians but may feel stuck or overwhelmed by other necessary roles in a small practice, such as:

Sales and enrollment
Marketing and social media
Bookkeeping and payroll
Legal, compliance, HR
Website maintenance
IT support

Exercise 2: Skills Gap Assessment

List your practice-essential skills that you’re strong in (clinical care, perhaps customer rapport, maybe accounting if you love it).
List the skills you don’t have or dread doing.

Reflection:If you’re spending extra hours slogging through tasks you’re inefficient at (or hate), you’re not only slowing practice growth but also risking faster burnout.

The Benefits of Hiring Early (Not Late)

Justin’s advice: Hire when your plate is only 50% full, not when it’s already overflowing. DPC practices can “firehose” unexpectedly—new patient sign-ups, sudden document surges, or unanticipated personal obligations. By having support in place before chaos sets in, you set yourself up for sustainable growth, patient satisfaction, and less stress.

Why Do DPC Practices Wait to Hire?

Fear of commitment (“Can I afford this?”)
Not knowing what to delegate
Wanting full control
Underestimating the growth curve

But as Dr. Concepcion reflects, energy drain—not just time drain—can be a tipping point. Even if you’re technically capable, tasks that sap your joy or rob you of family time provide a compelling case for help.

Practical Steps to Hiring the Right VA

A. Write a Clear Job Description

Use your audit exercises:

What are the three to five core outcomes or tasks you need taken off your plate?
What software or tools do they need familiarity with? (Jane, Hint, Spruce, etc.)
What qualities matter to you? (Attention to detail, communication style, medical terminology, bilingual, etc.)
What hours or availability do you need?

Pro-tip: If you feel stuck, use AI (like ChatGPT) to expand or organize your draft job description.

B. Robust Vetting and Testing

Skill Tests: Typing, spelling/grammar (very important for patient-facing roles), basic math (if handling financials)
Personality/Strengths Assessment: Use tools like High5Test to match candidates to the type of support you need (e.g., doer, thinker, connector).
Structured Interview: Focus on scenario and open-ended questions rather than yes/no. “How would you handle X? Tell me about a time you…” gives more insight into fit.
Trial Period: Always have a probationary or trial window before committing to long-term arrangements.

C. Use a Trusted VA Service—Like Cool Blue VAIf this all sounds daunting (or your bandwidth is maxed out), agencies like Cool Blue VA can streamline the process. They:

Pre-vet and train medical VAs with relevant experience (often three to five years minimum, often from the Philippines due to strong English and privacy standards)
Match you to candidates based on your exact criteria
Offer trial periods (Cool Blue offers a two-week, 80-hour, no-commitment trial!)
Manage HR, payroll, and compliance

Medical VA vs. Local Hire—Know the Distinction

Local Medical Assistant

Average cost: ~$20.84/hr (but agencies may upcharge to $30/hr+)
High turnover—study shows about 59% leave within a year
Pros: Needed for physical, in-person tasks (rooming, in-person vitals, vaccinations, assisting with procedures)
Cons: Training time/cost, compliance headaches, limited to in-person tasks, high cost for non-revenue roles

Medical Virtual Assistant

Average cost: ~$9.95/hr through Cool Blue VA
Qualifications: Typically have medical degrees or backgrounds (RN, pharmacist, lab tech); at least a bachelor's degree and several years’ experience
Pros: Can handle everything except direct patient contact (documentation, phone triage, insurance, referrals, Rx refills, billing support, marketing, and so on)
Pros: Consistency, reliability, scalable as you grow
Cons: Not physically in the office (can't do injections, draw blood, or hand patients tissues!)

Optimal Strategy:Use local team members only for revenue-generating, in-person functions. Delegate everything else (the “digital admin”) to a qualified, medically trained VA.

How to Get Started—Practical and Psychological Readiness

Practical Steps:

Do your audits (time/task and skills gap)
Write your job description (or get VA support to help you clarify)
Interview and test (yourself or via agency)
Take advantage of trial offers to ensure fit
Reflect and recalibrate—this is a nimble process; revisit your delegation list as your practice grows

Psychological Readiness:

Accept that letting go is challenging, especially for high-achieving physicians
Remember: Hiring a VA is not a loss of control, but a reclaiming of your best energy for your highest-value work
Using VA support is a sign of business maturity, not weakness

Impact—Beyond Just “Less Busy”

The ultimate win isn’t just feeling “less busy,” it’s:

Expanding your practice’s service capabilities and patient experience (faster replies, on-time labs, fewer dropped balls)
Growing your practice’s revenue by working at the “top of your license”
Reclaiming time for family, hobbies, and creative practice advancement
Preventing burnout by focusing on your purpose—not piles of paperwork

As Dr. Concepcion puts it, the “ugly reality of pajama time” can be replaced with peace of mind, sustainability, and joy.

Make the Leap—Your DPC, Upgraded

Whether your DPC is still on paper or years in, take time to honestly assess where your practice, your time, and your talents are best spent. Reflect on the real costs of doing everything yourself, not just in dollars but in days, weekends, and exhausted energy.

If you’re ready to explore the impact of a medical virtual assistant, services like Cool Blue VA streamline the process and even offer no-risk trials. Embrace the power of delegation for your DPC—and for the life you set out to build when you chose this model in the first place.

For more information, visit coolblueva.com/2weeks for a free practice analysis and trial, or stop by their booth if you’ll be at DPC Summit in New Orleans!