You Did Not Go to Medical School to Answer the Phone
- Maryal Concepcion
- 26 minutes ago
- 4 min read
There is a number that should stop every Direct Primary Care physician in their tracks.
Twenty-seven percent.
THAT is how much of the average physician's day actually goes to direct patient care. Nearly half of the rest disappears into desk work, inboxes, prior authorizations, and the long quiet hold music of trying to reach somebody else's office. For every hour you spend with a patient, you are spending close to two hours on everything that is not the patient.
Read that again, because it is the whole problem in one sentence. The work you trained for has become the smaller part of your day.
This came up recently at a workshop following the CALI DPC SUMMIT, where Justin Lam, the CEO of Cool Blue VA, sat down with a room full of physicians to talk about getting real help. Not someday. Not once the practice is big enough. Now, while you are still building. What follows is the thinking that stuck with me most, and why I keep pointing physicians toward the same place to start.
The question that decides everything
Justin shared a framework that is almost embarrassingly simple, and that is exactly why it works. He calls it the only you test.
Is this something only you can do?
Only you can diagnose and treat. Only you can build the doctor-patient relationship. Only you can do the procedures that require your license, and only you, as the owner, can set the strategy and the vision for your practice. That list is shorter than you think, and it is sacred.
Almost everything else is delegable. Scheduling. Patient portal messages. Chasing labs. Referrals and prior authorizations. Reminders. Records requests. Coordinating with specialists when your patient cannot get through on their own. None of that requires a medical degree. All of it is eating your evenings.
When Justin asked the room to add up the hours, the answer landed around fifteen hours a week. Fifteen hours you could hand off and get back. That is not a productivity hack. That is a different life.
Stop waiting until you are drowning
Here is the part most of us get wrong, myself included in the early days.
We wait until we are at one hundred percent to hire. We wait until we are buried, until we are answering messages at midnight, until something has clearly broken. And then the first person who walks through the door looks like a savior, so we hire fast, we hire wrong, and they are gone two months later. Now we are back at the start, more tired than before.
Justin's rule is to hire at fifty percent. When your plate is half full, not overflowing. That is when you still have the time to train someone well, the clarity to choose the right person, and the patience to set them up to succeed. Hiring is not what you do when you are out of options. It is what you do while you still have the runway to do it thoughtfully.
Local versus virtual, and why it is not either or
One of the most useful distinctions from the conversation was how to think about local help versus virtual help. They are not competitors. They have different jobs.
Your local medical assistant is for the high-touch, in-person, revenue-generating work that can only happen inside your four walls. Rooming and vitaling patients. Assisting with procedures and injections. Handling in-office payments and inventory. That hour is worth paying for because it is tied to your physical presence.
A virtual assistant covers the rest, and the rest is enormous. The inbox. Scheduling and rescheduling. Prior authorizations. Membership management. Records out, records in. Calling the pharmacy. Coordinating the specialist appointment your patient has been trying to book for two weeks. This is the invisible administrative weight that has nothing to do with your hands and everything to do with your time.
What surprised the room is how capable and how dedicated these team members are. Real medical professionals, working your hours, assigned to you and only you, week to week with no long lock-in. The retention is high because for them this is a career, not a stepping stone, which solves the painful cycle so many of us know of training someone up only to watch them leave within the year.
The part nobody expects
Toward the end, a physician asked the question that made the whole room lean in. So many of us are not just running a practice. We are the CEO of our households too. The camp schedules, the grocery lists, the flights for the talk you are giving next month, the dinner that needs to be ordered before the kids melt down.
Can a virtual assistant help with that too?
Yes. Justin's own assistant books his hotels, his flights, orders his lunch, handles the errands that quietly drain a day. Call it an executive assistant for your life. Because protecting your time is not only about the practice. It is about being able to show up as a physician, and as a parent, and as a human being, without all three competing for the same exhausted hour.
Where to start
If any of this landed, if you recognized your own evenings in these words, do not file it away as something to handle later. Later is how we end up at one hundred percent, hiring in a panic.
The smartest move you can make this week is to learn what real help actually looks like for a DPC practice like yours. Cool Blue VA built a path specifically for physicians who want to grow without burning out to do it.
Start here: coolblueva.com/dpcgrow
Go take a look. Map out the top few things eating your time, the way Justin walked the room through, and see what it would feel like to hand them off. You did not go to medical school to answer the phone. It is time your day reflected that.
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