Episode Summary: This episode provides a detailed update from Phil and Marina as they reflect on the current state of their direct primary care pediatric practices. They walk through what it looks like to approach and reach patient capacity, and the operational and emotional shifts that come with that milestone. They share practical insights into how growth impacts day-to-day workflows, patient access, and key decision-making.

A significant portion of the conversation focuses on hiring—one of the most complex aspects of scaling a DPC practice. They discuss considerations around bringing on additional physicians or team members, structuring compensation in a sustainable way, and ensuring alignment with the DPC model. The discussion highlights the importance of maintaining a strong cultural and philosophical fit as practices expand.

They also explore the financial and operational implications of growth, including balancing increasing patient demand with preserving the personalized, relationship-based care that defines DPC. The episode offers a candid look at the tradeoffs involved in scaling, along with practical insights for navigating this next phase of practice development.

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