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

Key Highlights: Transitioning to Direct Primary Care (DPC) with Dr. Laura Lindner

1. Motivation for Transition

* Dr. Lindner experienced growing frustration and burnout in her previous group practice due to a lack of autonomy, inefficiencies in patient care, and an inability to implement her ideas.

* She was inspired by colleagues and other DPC practitioners who demonstrated the potential for this model in pediatrics.

2. Initial Steps Toward DPC

* Dr. Lindner began by researching the DPC model through Facebook groups like "Pediatricians that do DPC" and "DPC Docs."

* She explored the financial feasibility of starting her own practice, including preparing for a temporary loss of income.

* A healthcare attorney helped her navigate her employment contract, focusing on non-compete clauses and patient record ownership.

3. Navigating the Transition

* To comply with legal restrictions, she used creative methods to inform patients about her new practice:

* Created a personal Instagram account to connect with patients indirectly.

* Shared updates about her life and later redirected followers to her professional page after leaving her employer.

* She emphasized the importance of maintaining professionalism during the resignation process, giving ample notice (four months) to avoid leaving her former practice in a difficult position.

4. Challenges Faced

* Finding office space within the constraints of her non-compete clause was particularly challenging. She eventually secured a rental arrangement for one exam room in an existing office.

* Establishing an online presence was initially difficult due to SEO limitations and issues with gaining control over her Google profile, which was managed by her previous employer.

5. Lessons Learned

* Dr. Lindner advises others transitioning to DPC to:

* Thoroughly review contracts with legal assistance.

* Plan for logistical aspects like securing a business address and managing online visibility.

* Maintain positive relationships with former colleagues and staff to facilitate smoother transitions.

6. Results and Reflections

* Within six months of opening Homegrown Pediatrics, approximately 5–7% of her former patients followed her to the new practice, increasing to about 10% over time.

* Despite initial fears, she successfully built a sustainable practice while maintaining ethical and legal standards.

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

Key Highlights:

* Journey into Direct Primary Care (DPC)

* Dr. Amber Hull transitioned to DPC after a disability from a femur fracture in 2021 forced her to reevaluate her career.

* She created Village Pediatrics, a low-overhead, concierge-style pediatric practice that focuses on house calls and direct patient access.

* Her practice primarily serves children under five, with many families joining during pregnancy.

* Postpartum Health & Women's Care

* Dr. Hull integrates maternal health into her pediatric care, recognizing the impact of postpartum hormone shifts on women's well-being.

* She educates families on the similarities between postpartum and menopausal hormonal changes, emphasizing issues like vaginal atrophy, decreased libido, and emotional challenges.

* She collaborates with pelvic floor therapists and mental health professionals to support new mothers holistically.

* Challenges in Postpartum Care

* The healthcare system inadequately prepares parents for postpartum challenges, including relationship changes and physical recovery.

* Many women experience a lack of medical guidance in navigating postpartum hormonal shifts and intimacy concerns.

* Dr. Hull encourages open conversations with both parents to foster understanding and support during postpartum transitions.

* DPC as a Sustainable Model

* Dr. Hull discusses the benefits of DPC in allowing her to balance patient care with self-care.

* She emphasizes the importance of setting boundaries, outsourcing non-medical tasks (e.g., bookkeeping, marketing), and maintaining financial sustainability.

* Unlike traditional healthcare models, DPC allows her to cultivate direct relationships with specialists and community resources.

* Resources & Continuing Education

* Dr. Hull is an advocate for improving physician knowledge in postpartum and sexual health.

* Recommended resources:

* International Society for the Study of Women’s Sexual Health (ISSWSH)

* Menopause Society

* Dr. Kelly Casperson's book & podcast: You Are Not Broken

* She will be speaking on menopause and intimacy at an upcoming medical conference.

Final Thoughts

Dr. Hull’s approach to DPC highlights the need for integrative, patient-focused care in pediatrics. By addressing postpartum health alongside infant care, she provides a holistic model that benefits both mothers and children. Her story is an inspiring example of how physicians can reshape their practice to align with both their values and well-being.

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