Podcast Summary:In this episode of DPC Pediatricians, Dr. Phil Boucher and Dr. Marina Capella dive into a fundamental question for anyone starting a Direct Primary Care (DPC) pediatric practice: What equipment do you really need at the beginning?

Key Highlights:

Start Lean and Grow as You GoNew DPC pediatricians often over-purchase equipment trying to mirror traditional practices. The hosts emphasize starting with only what’s essential — many fancy tools can wait or be added later.

Clinical Essentials FirstMust-have items include: stethoscope, otoscope, ophthalmoscope, infant + adult scales, and basic vitals tools. You don’t need expensive versions to provide great care.

You Don’t Need a Fully Stocked Exam RoomDr. Marina recalls seeing patients in a furniture-less room early on. Dr. Phil stresses using what's available and pivoting creatively (e.g., running to the hardware store for a black light last-minute).

Affordable Furnishings Work Just FineIKEA-style tables, secondhand furniture, and minimalist setups are completely acceptable. Keep it clean and functional; kids and parents care more about care than decor.

Lab Supplies Can Be MinimalStart with just rapid strep, flu, and urine tests. Sending labs to Quest or LabCorp is often more practical early on than drawing blood in-house — especially without an MA.

Don’t Let Labs Hold You BackGetting group purchasing discounts is helpful, but not required to launch. Most pediatric patients won’t need frequent labs, and many parents are used to outside lab billing.

Expensive Tools Can WaitBig-ticket items like vision screeners, lead testers, and hearing machines are nice but not needed immediately. Create a wish list tied to financial or patient milestones.

Paperwork Still MattersKeep printed forms handy (PHQ-9, postpartum screens, Ages & Stages, etc.). A small stock of printed materials can go a long way in well visits.

Tech & Admin BasicsA reliable laptop, printer, Wi-Fi router, and paper documents are sufficient to run a lean office. An EMR and e-prescribing setup are essential for functionality.

Be Flexible & CreativeYou’ll encounter unplanned needs (like Nair for a hair tourniquet or extra bandages) — just get them when they arise. Most items can be picked up locally.

Use Free & Community ResourcesHelpful tools include:

* The DPC Pediatricians Facebook Group (shared files with starter lists)

* Startup guides from dpcpediatrician.com

* The upcoming DPC Virtual Summit in September

Takeaway Message:

You don’t need a perfect, fully equipped practice to start seeing patients. Begin with clinical basics, build smart, spend conservatively, and expand your tools as your practice grows. The beauty of DPC is that you get to design your setup in a way that supports your vision and budget.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com

Podcast Summary:

In this episode of DPC Pediatricians, Dr. Phil Boucher and Dr. Marina Capella respond to recent legislation — the “One Big Beautiful Bill” — which is projected to strip 12–17 million people, including millions of children, of Medicaid coverage. They explore how Direct Primary Care (DPC) pediatricians can step in to help fill this critical gap.

Key Highlights:

A Massive Loss of Coverage Is ComingRecent federal legislation may result in millions of children losing access to Medicaid. This is expected to lead to downstream effects such as closures or service cuts at children’s hospitals and clinics, many of which rely heavily on Medicaid.

DPC Practices Can Serve the UnderservedDespite the perception that DPC is only for the affluent, both hosts emphasize that DPC pediatricians can and do care for uninsured and lower-income families.

Flat-Fee Visits Increase AccessMany immigrant or lower-income families avoid membership models due to psychological or financial barriers. Offering one-time flat-fee visits allows more flexible access, especially for acute concerns or school physicals.

“When families really need something, they will often find a way to pay for a visit — especially when it’s more affordable and faster than urgent care.”

Sliding Scale Memberships Can Be Life-ChangingBoth doctors offer discounted memberships (up to 50% or more) without requiring income verification. This flexibility enables care for families in tight situations while maintaining sustainability.

Creative, Community-Focused Care Models

* Providing free care to staff families

* Offering VFC vaccines and catching up under-vaccinated children

* Including developmental and speech screenings during other visits

The Idea of a Sponsorship FundDr. Marina shares a potential model: a community sponsorship fund supported by wealthier patients.

* Could be structured via optional membership tiers (e.g., pay extra to help another family)

* Note: These are not tax-deductible unless run through a formal nonprofit

* Personal relationships and transparency are key to getting buy-in from community members

Advocacy as a DPC SuperpowerDPC physicians have more time and flexibility to get involved in advocacy work than many traditional physicians.

* Participating in state chapters of the AAP or medical associations allows you to testify, vote, and influence policy

* Both hosts share stories of real-world legislative impact (e.g., protecting mandatory newborn screenings)

“You have more influence than you think. Legislators listen when a pediatrician speaks.”

A Hidden Win in the New Law: HSA EligibilityThe new bill also contains a small but helpful clarification: DPC is not health insurance, and up to $150 per member can be paid with HSA funds — a positive step for patients trying to use pre-tax dollars for care.

Takeaway Message:

Although millions may soon lose Medicaid, DPC pediatricians are uniquely positioned to help — by offering flexible access models, sliding scale memberships, advocacy, and community-driven solutions. With time, creativity, and a heart for service, DPC can bridge gaps in a changing healthcare landscape.

Special Announcement:Registration is now open for the first-everDirect Pediatric Care Virtual Summit – Fall 2025Free to attend at: dpcpediatrician.com/summitContent for every stage: curious, launching, growing, or thriving

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com

Podcast Summary:

In this episode of DPC Pediatricians, Dr. Phil Boucher and Dr. Marina Capella address a common concern among physicians considering or practicing Direct Primary Care (DPC): how to handle weekend availability without compromising personal time or patient care.

Key Highlights:

* Weekend Worries Are Common but Manageable

Many physicians worry about being on-call 24/7 in a solo practice, especially on weekends. Both hosts affirm this concern is valid but emphasize that the reality is often far less stressful than expected.

* Setting Weekend Office Hours

Phil's practice offers limited Saturday morning hours (8–10 AM), split among providers. Over three recent weekends, only one Saturday visit occurred, showing that weekend demand is often minimal.

* Patient Communication is Key

Patients are trained to reach out early on Saturdays if needed. An automatic message sets expectations about office availability and response times for non-urgent vs. urgent concerns.

* Texting on Weekends

Physicians typically monitor texts on weekends, especially for simple questions. If urgent care is needed, patients are directed to trusted facilities. Newborns or serious cases are referred to the ER with proper guidance and notification.

* Delegating and Covering Time Off

When out of town, Marina communicates transparently with patients and uses a covering pediatrician when needed. Most issues can still be handled via text.

* Clear Expectations Prevent Burnout

Setting and enforcing boundaries during onboarding helps patients understand when and how their pediatrician is available. Respect for the physician’s humanity and life outside the clinic fosters mutual trust.

* Flexible and Dynamic Scheduling

Marina structures her schedule around personal priorities, like spending summers at a mountain cabin or working only specific days. Patients are understanding when expectations are communicated.

* Adult vs. Pediatric DPC

Pediatric DPC tends to involve more weekend support than adult DPC, due to the nature of children's needs and parental anxiety. However, this support can still be well-structured and limited.

* Practice What Works for You

The beauty of DPC is the autonomy to design a schedule that supports both your personal and professional life. Experimenting with availability and structure is encouraged and often leads to improved satisfaction.

* Patient Retention Supports Boundaries

Neither host has experienced patients leaving their practice due to limited weekend availability. In rare cases where expectations aren’t aligned, a respectful referral to another provider is appropriate.

Takeaway Message:

DPC allows pediatricians to set boundaries, build sustainable schedules, and still provide excellent care. Clear communication, mutual respect, and smart planning make it possible to enjoy both a fulfilling practice and personal life.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com

Key Highlights:

In DPC pediatric practices, text messaging and selective telehealth use foster meaningful, efficient, and family-centered care. By embracing modern communication styles and setting clear boundaries, DPC physicians are redefining how pediatric care is delivered—with less stress, more connection, and greater flexibility for both families and providers.​

1. Text Messaging for DPC Practices

* Texting is a great feature DPC clients love to use.

* It aligns with modern parents’ communication preferences—especially millennials who dislike phone calls.

* Texting creates a faster, more convenient, and less stressful experience for families.

2. Transitioning from Fee-for-Service Mindset

* Initial hesitation around texting (e.g., fear of being overwhelmed) disappears once providers experience the manageable volume of communication in DPC.

* The shift from a panel of thousands of patients to smaller, intentional patient panels reduces burnout and increases connection through text.

3. Efficient Care Without Office Visits

* Many issues can be resolved via text or photos—e.g., diaper rash, pink eye, or a bug bite—saving families time and unnecessary visits.

* Examples include avoiding full office visits for simple questions like constipation or bug bites.

4. Personalized, Ongoing Care

* Unlike large healthcare systems, DPC physicians build personal relationships with patients and families, leading to more thoughtful, individualized care.

* Patients often prefer asynchronous communication with someone they know and trust over impersonal telehealth with unfamiliar providers.

5. Managing Message Volume and Expectations

* Physicians set boundaries around response time (typically same day, not instant).

* Automated replies help set after-hours expectations and offer booking options or advice for urgent needs.

* Teams often triage messages first thing in the morning and during downtime.

6. Recognizing Urgency Without Overreacting

* Physicians discuss the psychology of interpreting urgency and how most parents are seeking reassurance—not demanding immediate appointments.

* They encourage trusting relationships where patients feel heard without needing instant access 24/7.

7. Minimal Use of Video Visits

* Contrary to initial expectations, video visits are rare.

* Asynchronous methods (texts, pictures, short videos) often work better than live video, which can be awkward or unnecessary.

* Video visits are occasionally used for behavioral health consults or special cases.

8. Texting Builds Trust & Peace of Mind

* Knowing they can easily reach their physician brings parents peace of mind.

* The model promotes trust and reduces unnecessary stress or reliance on unverified online sources.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com

In this candid and inspiring episode, Phil and Marina explore the theme of failure—how it's an inevitable part of the human and entrepreneurial experience, and more importantly, how to learn and grow from it. They share personal stories of setbacks, including missteps in business ventures, early academic struggles, and social media flops, underscoring that failure is not the end but a stepping stone to success. The episode encourages fellow pediatricians, especially those in or considering irect primary care, to frame failure as a growth opportunity rather than a stopping point.

Key Highlights

* Reframing Failure: The hosts emphasize that failure is a natural and necessary part of learning—just like in child development, where kids must fall before they walk.

* Cultural Challenges in Medicine:

* Medicine often penalizes failure harshly, especially during training, which leads to a deep-rooted fear among physicians.

* In entrepreneurship, however, failure is less risky and often essential for learning.

* Phil’s Experiences:

* Launched a virtual membership inspired by Blueberry Pediatrics that didn’t gain traction but led to a new patient retention strategy.

* Attempted to start a clinic-based pharmacy, which failed due to regulatory and logistical issues—highlighting the importance of focusing on what patients truly need.

* Uses social media prolifically and embraces that many posts will flop. He views each post as an experiment and doesn’t dwell on metrics.

* Marina’s Vulnerability:

* Shared her experience of failing foundational biology courses at Stanford and how she overcame academic setbacks to eventually succeed in medicine.

* Spoke candidly about taking an extra year in medical school due to depression and how she found her stride during clinical rotations.

* Takeaway Mindset:

* Progress is not linear. The journey includes setbacks, and resilience is built by continuing through them.

* Physicians have the training and adaptability to recover from business failures.

* Having community and mentorship makes the process of learning from failure more manageable and less isolating.

* Call to Action:

* For pediatricians in or considering DPC, the takeaway is: don’t let fear of failure stop you. Try, pivot, and adapt.

* Phil and Marina also offer one-on-one consulting through their site, dpcpediatrician.com, to support others on this path.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com

Podcast Episode Summary: Setting and Reaching Goals with Purpose

Hosts: Dr. Phil Boucher & Dr. Marina Capella

Book Discussed: All It Takes Is a Goal by John Acuff

Key Highlights

Overview of the Book

* All It Takes Is a Goal explores how to identify, prioritize, and achieve meaningful goals.

* Acuff uses personal anecdotes and practical frameworks to help readers move from “idea” to “action.”

* Especially relatable for perfectionists, over-thinkers, and high-achievers.

Identifying Meaningful Goals

* Best Moments List: Reflect on past experiences that brought you joy to guide future goals.

* Avoid “should” goals (based on external expectations) in favor of goals rooted in personal fulfillment.

Three Types of Goals

* Easy Goals

* Timeframe: 1–7 days

* Low effort, low cost, builds momentum

* Examples: Send an email, post on social media

* Middle Goals

* Timeframe: 30–90 days

* Requires scheduling and consistency

* Examples: Organize a clinic event, create a new service line

* Guaranteed Goals

* Timeframe: 3–12 months

* Must be within your control and measurable

* Examples: Train for a half-marathon, take regular voice lessons

Lessons Applied to DPC Life

* Both hosts discuss personal examples: starting autism support services, planning clinic events, learning new skills (like singing).

* Importance of breaking large goals into achievable steps and celebrating small wins.

* Middle and guaranteed goals often involve delegating and time management — crucial in DPC practice.

Perfectionism and Progress

* Perfectionism is a common “goal killer,” especially among physicians.

* Phil stresses the value of “B+ work” over paralyzing perfection.

* Emphasis on building confidence through small successes.

Finding Time for Goals

* Acuff encourages reclaiming “hidden time” (e.g., waiting in the car line, at the airport).

* Quote: “The reason you're busy is because your imagination is bigger than your calendar.”

Working Genius Concept

* Phil also introduces The Six Types of Working Genius by Patrick Lencioni.

* Recognizing your team’s strengths (idea generation, follow-through, execution) helps with delegation and goal completion.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com

Episode Summary: Standing Out Amongst the Competition

In this insightful episode, Drs. Phil and Marina explore how direct primary care pediatricians can differentiate themselves in a crowded healthcare market, particularly in contrast to traditional fee-for-service models.

Key Highlights & Takeaways

The Changing Landscape of Patient Choice

* In traditional models, patients often choose providers based on insurance coverage and proximity.

* In DPC, patients actively choose to pay out-of-pocket for care—so practices must compellingly demonstrate value.

Standing Out: Being “Better” vs. Being “Different”

* Being Better: Focus on reducing hassles—like offering same-day visits, online scheduling, and text communication.

* Being Different: Emphasize unique offerings like integrative care, longer visits, personalized attention, or specialties (e.g., PANDAS care, mind-body medicine).

Benefits Over Features

* Features are things like “text messaging” or “longer appointments.”

* Benefits are what those features mean to patients: peace of mind, deeper relationships, feeling heard.

* Patients buy emotional outcomes, not logistical details.

Marketing & Messaging

* Avoid bland explanations of DPC.

* Don’t just list services and hours on your website—highlight emotional and relational benefits.

* Use testimonials and storytelling to bring benefits to life.

Consumer Psychology

* Position your practice like a luxury or specialty product (e.g., glass-bottled flavored milk vs. plastic gallon jug).

* Create perceived value that justifies patients choosing and paying for your care over a "free" option.

Actionable Advice

* Review your website today and rewrite at least one feature as a benefit.

* Use ChatGPT or a marketing lens to frame how you communicate your practice’s value

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com

Podcast Episode Summary: DPC Pediatrician — Zest Pediatric Network

Host: Dr. Marina Capella

Guests: Dr. Drew Hertz & Dr. Keili Mistovich (Co-founders, Zest Pediatric Network)

Episode Overview:

This episode features an in-depth conversation with Dr. Drew Hertz and Dr. Keili Mistovich, co-founders of the Zest Pediatric Network. The discussion centers on how Zest is transforming the landscape for pediatricians interested in Direct Primary Care (DPC) by providing a supportive, collaborative network model that lowers barriers to entry, maintains physician autonomy, and enhances patient care.

Key Highlights

Why Zest Pediatric Network Was Created

* Zest was founded to make it easier for pediatricians to enter the DPC model, especially for those who are hesitant to manage all business and clinical responsibilities alone.

* The network aims to lower barriers for doctors who may not have business experience or resources to start independent practices.

* The founders believe every pediatrician should have access to the DPC model, not just those with entrepreneurial backgrounds.

Team-Based Approach

* Zest operates on the philosophy that "DPC is a team sport," offering pediatricians the benefits of independence with the support of a collaborative team.

* The network provides two main types of support: Business Team: Handles back-office operations, freeing doctors from administrative burdens so they can focus on patient care. Clinical Team: Offers cross-coverage among doctors, making it easier to take vacations and manage time off without compromising patient care.

Expanded Services Through Economies of Scale

* By pooling resources, Zest offers access to additional professionals—nutritionists, sleep consultants, lactation consultants, psychologists—who support comprehensive pediatric care.

* These services would be difficult for solo practitioners to afford or coordinate independently, but are feasible when shared across multiple offices.

Network Structure and Autonomy

* Each doctor operates as an independent LLC, preserving their autonomy and preventing the network from becoming a corporate healthcare system.

* Zest emphasizes a "servant leadership" model, where the network supports the physicians rather than employing them, and clinical support professionals are also independent contractors.

* The structure allows doctors to have equity in the network and a say in its development and direction.

Operational Efficiency and Growth

* Zest has successfully launched multiple offices (three in Cleveland, two in Pittsburgh) and can help new practices become operational quickly—sometimes within three months.

* The network manages everything from patient onboarding to administrative tasks, allowing doctors to focus solely on clinical care.

Integration and Community Partnerships

* Zest has established contracts with schools, Medicaid, and therapy centers, enabling broader service offerings such as autism assessments and evaluations.

* The network's unified electronic medical record (EMR) system allows seamless sharing of patient information among the team, ensuring coordinated care.

Maintaining the DPC Ethos

* The founders stress their commitment to preserving physician autonomy and avoiding the pitfalls of corporate medicine, which many DPC doctors seek to escape.

* Decision-making within the network prioritizes the independence and preferences of member physicians.

Notable Quotes

"DPC is a team sport because not everybody wants to go it alone."

"We work for the doctors. The doctors don't work for us."

"Maintaining autonomy for our physicians is always front of mind when making decisions about the network."

Conclusion

Zest Pediatric Network offers a unique, scalable solution for pediatricians interested in DPC. By combining business and clinical support, expanding access to ancillary services, and maintaining physician autonomy, Zest enables doctors to focus on what they love—caring for children—while enjoying the benefits of teamwork and shared resources.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com

In this episode of DPC Pediatrician, Dr. Phil Boucher and Dr. Marina Capella dive into the frequently debated topic of whether DPC practices should charge an enrollment fee. They share their personal experiences, perspectives, and practical advice for pediatricians considering this approach.

Key Highlights

1. What Is an Enrollment Fee and Why Consider It?

* An enrollment fee is a one-time charge for new patients joining a DPC practice. It helps offset the upfront time and effort spent on onboarding families, such as reviewing medical records, conducting lengthy initial visits, and creating follow-up plans.

* Dr. Capella initially disliked the idea of enrollment fees but later found them beneficial for protecting against families who leave shortly after joining, despite significant upfront investment.

2. Benefits of Charging an Enrollment Fee

* Commitment Indicator: The fee encourages families to think carefully before signing up, ensuring they understand the membership model.

* Financial Protection: It provides a buffer for the time-intensive onboarding process.

* Clarity: It reinforces the idea that DPC is different from traditional practices, helping patients understand the recurring membership structure.

3. Practical Approaches to Enrollment Fees

* Both doctors charge $100 per family as a reasonable fee but note that practices can set their own amount or waive fees in certain situations (e.g., newborns or special cases).

* Waiving fees can be used as an incentive to encourage sign-ups during meet-and-greet sessions.

4. Alternatives to Enrollment Fees

* Minimum Membership Commitment: Practices can require families to commit to a minimum duration (e.g., six months) instead of charging an enrollment fee. This ensures stability while avoiding upfront costs.

* Flexible Policies: Some practices opt not to charge enrollment fees or enforce commitments to minimize barriers for families, especially in lower-income or rural communities.

5. Tailoring Fees to Your Community

* Pricing strategies should reflect the economic realities of your patient base. For example, in areas with lower average incomes, an enrollment fee might deter families from joining.

* Testing your market and adjusting policies based on feedback is crucial for success.

6. Final Thoughts

* The beauty of DPC is its flexibility—practitioners can decide whether to charge fees or enforce commitments based on their values and community needs.

* Both Dr. Boucher and Dr. Capella emphasize that it’s okay to experiment with different approaches and adjust as needed.

For more content like this please visit, https://dpcpediatrician.com.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com

In this episode of DPC Pediatrician, hosts Dr. Phil Boucher and Dr. Marina Capella welcome Dr. Dhanu Sant and Dr. Valerie Miles from ThriveWell Pediatrics in Jacksonville, Florida. The discussion centers on their journey into direct primary care (DPC), their partnership model, and how integrative medicine shaped their practice.

Key Highlights:

1. Backgrounds of the Guests:

* Dr. Sant's Journey:

* Originally from Columbus, Ohio, Dr. Sant trained at Ohio State University and Columbus Children’s Hospital.

* She began her career in a large pediatric practice but grew frustrated with the limitations of fee-for-service care, particularly the lack of time to address foundational health issues like nutrition and sleep.

* Inspired by her Indian heritage and yoga practice, she transitioned to integrative medicine and started her own pediatric practice in Columbus.

* In 2019, she decided to move to Florida for family reasons and began exploring a partnership with Dr. Miles.

* Dr. Miles' Journey

* Trained in Salt Lake City, Dr. Miles felt drawn to pediatrics early in her career.

* She practiced in Durango, Colorado, where she encountered holistic approaches like garlic oil for ear infections, which sparked her interest in integrative medicine.

* After moving to Jacksonville in 1999, she started her own insurance-based integrative practice in 2000 and became board-certified in integrative medicine.

2. Formation of ThriveWell Pediatrics:

* Drs. Sant and Miles met through integrative medicine conferences and maintained a supportive professional relationship over the years.

* In 2019, they decided to combine their expertise and open ThriveWell Pediatrics as a direct primary care (DPC) practice in Jacksonville.

* They attended the Nuts & Bolts DPC conference, which provided the foundational knowledge needed to launch their practice in 2020.

3. Benefits of Their Partnership Model:

* The doctors emphasized the importance of finding the right partner, likening it to a marriage.

* They balance responsibilities based on their strengths, such as accounting and patient communication, making the workload more manageable.

* Both agreed that having a partner enhances the experience of running a practice compared to doing it solo.

4. Integrative Medicine in Pediatrics:

* Both doctors highlighted how integrative approaches—such as addressing nutrition, sleep, and natural remedies—can be transformative for pediatric care.

* Their shared vision for holistic care was instrumental in shaping ThriveWell Pediatrics into a unique DPC model.

For more content like this please visit, https://dpcpediatrician.com.

This is a public episode. If you would like to discuss this with other subscribers or get access to bonus episodes, visit dpcpediatricians.substack.com