Dr. Kyle Rickner heard about Direct Primary Care in a side room at the AAFP National Conference in October 2014 and committed to it 50 minutes later. Today Primary Health Partners cares for employee lives in 30 states, and it started with a patient named Jason who owned a 22 person company and handed Dr. Rickner a check covering every employee for a full year, six weeks after opening.

In this episode, Dr. Rickner talks with Dr. Maryal Concepcion about what it takes to build a DPC practice that serves employers without giving up autonomy. He opened with 198 members on day one after a 15 month runway, a $1,000 equipment haul from a shuttered nursing program, and a lot of honest conversations with patients he wanted to bring with him.

He also gets direct about the mistakes he sees. Enrollment is not engagement. A 375 employee contract can gut a 600 patient panel overnight if that company sells or closes. And overpromising to an employer poisons the well for the next DPC doctor who walks through that door.

What you will hear:

• Why commitment and enthusiasm persuade patients faster than any marketing budget
• The three pillars Primary Health Partners built on before opening the doors
• How to identify a good employer partner, and when to say no
• Utilization differences between retail members and employee members, and why adoption rates range from 10% to 92%
• How he built a 28 doctor affiliate network in three weeks using DPC Mapper
• What he thinks about private equity and venture capital money entering DPC, and the two non-negotiables that protect your practice
• Why passive customer acquisition channels may be how DPC reaches the next tens of thousands of patients
• Lessons on autonomy from practicing inside the Army health system

Find resources and your next step at mydpcstory.com, including the free startup checklist and the Physician Owner's Planner built for the business side of practice ownership.

Leave a voice message at mydpcstory.com/contact and your question could be featured on a future episode.

Follow My DPC Story on socials @mydpcstory.

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Two months after opening Amity Creek Primary Care in Duluth, Minnesota, Dr. Nyasha Spears returns to My DPC Story with the real numbers, the real costs, and the parts of a Direct Primary Care startup nobody puts on a slide.

She and her DPC partner Dr. Kristin Lusian hit 130 patients six weeks in, with no advertising beyond a website and word of mouth. As of June they are covering overhead, rent, and debt payback, though they are not paying themselves yet. Meanwhile the non-compete case that made the opening possible is still moving. Her former employer appealed the temporary injunction and filed a motion to stay, so Dr. Spears is funding an appellate defense while building a brand new practice from scratch.

In this episode:

• What a non-compete fight really costs, and what physicians considering the legal path should prepare for financially and emotionally
• Why keeping membership prices low was a boundary decision, not only a pricing decision
• How she handles patients wanting care her practice does not offer, and when "no" beats "yes, with limits"
• The justice and equity case for DPC, and why she is focused on patients who fall through the safety nets rather than on replacing Medicare and Medicaid
• Boring wins worth celebrating: custom patient ringtones so calls stop landing in personal voicemail, decoding hospital lab orders with CPT and ICD codes, and 12 successful blood draws in five weeks
• Two-physician cross coverage, planning the first vacation, and the schedule she rebuilt once her husband started working three days away
• Keeping skills sharp with journal club, procedures, and actually reading again
• Why she says the more DPC the better, even in her own city

Maryal also shares how Big Trees MD partnered with Calaveras County Health so uninsured patients get same-day help, including one patient who went from panicking about medication access to picking up a prescription within eight hours.

If you are weighing a non-compete, pricing your memberships, or wondering whether patients will actually come, this conversation is the honest version.

Resources mentioned:
Amity Creek Primary Care: amitycreekclinic.com
Advocacy with the DPC Coalition: dpcare.org
Big Trees MD: bigtreesmd.com

Find your starting point at mydpcstory.com, from the free startup checklist to the Physician Owner's Planner built for the business side of your practice.

Leave Maryal a voice message at mydpcstory.com/contact. Your question or win could be featured on a future episode.

Follow @mydpcstory and please leave a five star review on Apple Podcasts so more physicians find these stories.

Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare.

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Recorded LIVE on the floor at the AAFP Co-sponsored DPC Summit in New Orleans, Dr. Angela Andrews of Direct Primary Care of West Michigan and Dr. Nicholas Jones of Clear Health Direct Primary Care in Eugene, Oregon sit down with Dr. Maryal Concepcion for an honest roundtable on what changes between year one and year three of direct primary care practice ownership.

Both opened in November 2023. Both came to New Orleans with a list. What they say out loud is what most physicians only think: the workflows you built on day one and never revisited, the boundaries you are usually the first to cross, and the succession question this movement has not solved yet.

IN THIS EPISODE

Physician owned regional DPC networks, and using them for call coverage, internal locums, and physician funded startup loans instead of banks

Why you do not need a nonprofit to do nonprofit work

Revisiting the workflows you built when you were solo, and what to automate, eliminate, or document

Employers as the next phase of DPC growth, and the arrival of employed DPC positions

Boundaries, moral injury, and why the physician is usually the first one to violate the boundary

How to handle one star reviews and trolls without losing your weekend

Succession planning, and what happens to patients when a DPC physician gets sick or closes

Oregon's corporate practice of medicine law, the non compete ban, and what advocacy looks like when you own your practice

Getting onto your state chapter committees, and why DPC needs representation at AAFP and state academies

Spouses, kids, and the family roles that quietly keep practices running

Choosing an EHR you will not have to leave in three years

MENTIONED IN THIS EPISODE

Dr. Emily Holt, Dr. Esther Khatibi, Dr. Julie Gunther, Dr. Timothy Blain, Dr. Phil Eskew, Dr. Jill Scherer, Dr. Clodagh Ryan, Dr. Neil Douglas, Dr. Hailey Miller, Dr. Amy Tressan, and Shaunna Sanders

RESOURCES

The Toolkit Magazine, including this year's Battle of the Support Stack and last year's Battle of the EHRs: toolkit.mydpcstory.com

The Physician Owner's Planner Limited First Edition Bundle: mydpcstory.com/shop

PHYSICIAN OWNER'S PLANNER BUNDLE

Fifteen available. Each one includes the printed Physician Owner's Planner in a binder, the digital bundle with our Medicare and Medicare Advantage Open Enrollment Guide, the yellow "Insurance is not healthcare" T-shirt, and a personal website review from Dr. Maryal Concepcion and Nathalia Hyland, head of marketing and strategy at My DPC Story. Limited shirt sizes remain. mydpcstory.com/shop

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From physician assistant to DPC physician, Dr. Reid Lancaster took the long road on purpose. In this episode of My DPC Story, he sits down with Dr. Maryal Concepcion to trace his journey from PA to DO and the moment a three-minute news clip about direct primary care planted a "worm in his brain" he couldn't shake.

Dr. Lancaster is the founder of Ethos Modern Medicine in La Quinta, California, just outside Palm Springs in a community as economically diverse as almost anywhere in the country. He shares why he chose to become a physician rather than practice independently as a PA, the honest differences he sees between PA, NP, and physician training, and how residency shaped what he can now do for his patients in primary care.

This conversation is packed with practical wisdom for anyone weighing a DPC of their own. Dr. Lancaster opens up about the naysayers he faced through medical school and residency, the mentors who pushed him to "cash in" on a traditional job, and the wife who kept the dream alive when the doubt crept in. He also reflects on the business side he never trained for, from California compliance surprises to the taxes and systems that fall through the cracks in year one and beyond.

You'll hear the real stories behind the lessons: the AI answering service named Jarvis that tanked his consults by 80 percent, the patients stuck in referral limbo despite having insurance, and the goals he wrote down before opening that he rediscovered in an old drawer. Dr. Lancaster makes the case that mistakes are lessons, that hiring a little earlier than feels comfortable can accelerate growth and protect your quality of life, and that clear boundaries set upfront are what keep DPC sustainable.

Now three and a half years in and effectively full at 600 patients with no marketing, Dr. Lancaster reflects on what growth looks like from here, the working partnership he's exploring with PAs and NPs in the DPC space, and why the local coffee shop model, not the franchise, may be the future of direct primary care.

Whether you're a pre-med student, a resident or a physician eyeing the exit from fee-for-service, or a DPC owner thinking about your next step, this episode is a reminder that you've done hard things before and you can do this too.

Head to mydpcstory.com to find your starting point, and come say hi at the AAFP co-sponsored DPC Summit in New Orleans.

Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare.

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When Dr. Timothy Blain opened his direct primary care practice in the middle of COVID, he finally felt like a “real doctor” again — after two decades of employed medicine, five-year burnout cycles, and the constant ache of knowing he could help patients but never had the time.

In this honest and moving episode, Dr. Blain shares his full journey: graduating in 2000 as hospitals bought up practices, surviving non-Hodgkin lymphoma at 38, then weathering COVID pneumonia, a heart attack, and adult-onset Still’s disease — all while continuing to care for his patients. He opens up about how DPC helped save his marriage, why empathy is the first thing burnout takes from physicians, and what it truly means to be the patient when you’re also the doctor.

Dr. Concepcion and Dr. Blain dig into:

•The 5-year burnout curve, and why “just take a half day” never works

•Building patient loyalty so deep that almost no one left, even through his hospitalizations

•Practical steps for leaving employed medicine for DPC (including the prepay discount that funded his startup)

•Why DPC doctors may be best positioned to use AI in medicine

•Supplements, home visits, ultrasound, and staying curious as a physician

•How and why he chose to close his practice — the taxes, timing, and grief involved

•Redefining “failure” and finding peace in a one-year sabbatical

Whether you’re burned out and dreaming of a way out, a few years into your own DPC, or simply wondering what a fulfilling end to a medical career can look like, this conversation is a breath of fresh air.

“Failure is in the eye of the beholder.”

 — Dr. Timothy Blain

—

📞 Leave Maryal a voicemail at mydpcstory.com/contact — your question or win might be featured on a future episode.

Come say hi at the AAFP co-sponsored DPC Summit in New Orleans!

Explore free tools for every stage of your DPC journey — the 90-day startup checklist, and the Physician Owner’s Planner — at mydpcstory.com.

Enjoyed this episode? Leave a 5-star review on Apple Podcasts, and check out our Patreon for commercial-free, extended episodes.

Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare.

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What does it look like to build a Direct Primary Care practice that protects your health as fiercely as it protects your patients? In this episode of My DPC Story, Dr. April Soto of Love and Light Integrative Medicine in South Pasadena, California shares how she systematically exited corporate medicine over three years and built an integrative DPC practice rooted in authenticity, boundaries, and healing.

After more than a decade in fee-for-service family medicine and infectious disease, including HIV care, Dr. Soto completed an integrative medicine fellowship, trained in ketamine-assisted therapy, and opened a micropractice designed around her own capacity as a physician living with chronic illness and mast cell activation syndrome (MCAS). Today she receives MCAS referrals from specialists across the country and offers ketamine journeys, transgender care for patients from age three to eighty, and deeply unhurried visits that can run four hours.

In this conversation, Dr. Soto and host Dr. Maryal Concepcion discuss:

• Why she left corporate medicine and how she planned her three-year exit
• Facing fears around money, homelessness, and financial security before opening a DPC
• Pricing as a quality-based practice instead of competing on discounts
• What she learned from giving too many discounts in year one
• How her assistant Natalie supports meet and greets, workflows, and boundaries
• Building an inclusive practice for LGBTQIA+ patients, immigrant communities, and neurodivergent patients
• Caring for patients afraid to seek care because of ICE enforcement
• MCAS diagnosis, testing pitfalls, and why these patients need a different kind of visit
• Ketamine-assisted therapy pricing, informed consent, and managing patient expectations
• Burnout, trauma as a superpower, and why inclusivity has to include the physician
• Her five-year vision: wellness contracts, motivational speaking, and growing her team

Whether you are planning your DPC launch or working to make your existing practice more sustainable, this episode is a masterclass in valuing yourself, honoring your capacity, and practicing medicine on your own terms.

Learn more about Dr. April Soto at Love and Light Integrative Medicine in South Pasadena, CA.

Visit mydpcstory.com for the free 90-Day Startup Checklist, the Physician Owner's Planner, and DPC tools for every stage. Leave a voicemail at mydpcstory.com/contact and you might hear it on a future episode. Support the show on Patreon for commercial-free and extended episodes.

Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare.

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When most physicians hear the word sustainability, they think about keeping the doors open. But after a weekend with more than 80 doctors at the California DPC Summit, our host Dr. Maryal Concepcion came away certain it means so much more. In this episode of My DPC Story, five voices from the Direct Primary Care community share what makes a medical career, a practice, and a life sustainable.

The throughline is simple. Healthcare becomes sustainable when the people providing the care are allowed to thrive.

You will hear from:

Dr. Deepti Mundkur, My Happy Doctor, nearly six years into DPC, on how continuity and deep patient relationships became her real measure of sustainability, including watching patients need less medication over time.

Dr. Shannon Connolly of Open Arms Direct Primary Care on how community and physician innovation build confidence, and why scaling DPC looks nothing like the venture-backed version.

Dr. Dedra Beckles on knowing your worth, protecting your energy, and why boundaries are not optional if you want to keep showing up with joy.

Dr. Grace Hassell on authenticity, presence, and a powerful highlining metaphor for becoming the doctor she wrote about in her personal statement.

Noreen Gutierrez, RN, on building sustainable teams through head, heart, and hands, and her five Rs for clinic culture.

Registration is open for the Illinois DPC Summit this October in the Chicagoland area, and for California's third annual DPC Summit next year. Find both on the Events page at mydpcstory.com.

If you will be at the AAFP co-sponsored DPC Summit in New Orleans, come say hi, grab the latest magazine, and share your story on a live mic.

Want a summit in your state? Send us a note through the contact page at mydpcstory.com. Tennessee is already in the works.

Leave me a voicemail at mydpcstory.com/contact and you might hear it on a future episode.

For commercial-free episodes, extended conversations, and the State by State with Dr. Phil Eskew series, check out our Patreon.

If this episode moved you, please leave a five-star review on Apple Podcasts. It helps other physicians find these stories when they need them most.

Keywords: direct primary care, DPC, DPC physician, physician burnout, sustainable medical practice, California DPC Summit, Illinois DPC Summit, membership medicine, family medicine, My DPC Story

Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare.

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What if you could get back fifteen hours of your work week without seeing a single extra patient?

In this special episode, recorded live in a breakout room workshop following the California DPC Summit, Justin Lam, CEO of Cool Blue VA, sits down with a room full of physicians to talk about getting real help in your practice and in your life. Dr. Maryal Concepcion opens by sharing her own experience working with a virtual assistant she found through Cool Blue VA, then hands the room over to Justin.

Justin walks through the questions so many physicians sit with when building a Direct Primary Care practice. Research shows only twenty-seven percent of a physician's time goes to direct patient care, while nearly half disappears into desk work and admin. Justin breaks down how to change that.

You will hear:

The "only you" test for deciding what to delegate and what to keep. If someone else can do it, it probably should not be on your plate.

Why fifty percent is the right time to hire, not one hundred percent, and how waiting too long leads to rushed decisions and the wrong hire.

How to design your ideal role before you ever start looking, including the top tasks to hand off, the tools your assistant will use, and how to measure success.

The real difference between a local medical assistant and a virtual assistant, and what each one is best suited for. Local staff handle high-touch, in-person, revenue-generating work. Virtual assistants cover the inbox, scheduling, prior authorizations, records, specialist coordination, billing, and more.

Practical hiring tools you can use today, from spelling and math checks to typing tests and strength assessments.

The honest back and forth with physicians in the room, who ask about charting support, inventory, time zones, vacation coverage, billing by the minute, and even using a virtual assistant as an executive assistant for your home life.

Whether you have a full panel or you are still mapping out your first month open, there is something here worth holding onto.

Ready to grow your practice with the right support? Start here: coolblueva.com/dpcgrow

A quick note on the audio. Because this was captured in a smaller breakout space, the sound gets tricky in spots. Thank you in advance for your patience with it.

Connect with My DPC Story:
 Listen, subscribe, and explore more at the My DPC Story podcast and media platform.

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What happens to a family physician when the system that trained him decides he no longer has value? In this deeply personal episode, Dr. Maryal Concepcion hands the introduction to a special guest, then sits down with her husband, Dr. Jeremiah Fillo of Big Trees MD, for an honest conversation about sustainability, not just as a doctor, but as a whole person.

Dr. Fillo shares the path from rural Nebraska training under Dr. Tim Blecha (Blay-kee), through residency in Modesto, into a corporate regional medical center that slowly turned the heat up the way you would on a frog in a pot. He talks candidly about the evergreen contract, the exclusivity clause, and the moment he was told to sign or be terminated while his wife was pregnant. He describes being let go and replaced by a non-physician model, the AB 890 reality in California, and the months of uncertainty that followed.

This is also a conversation about what comes after the devaluation. Dr. Fillo opens up about how he held onto his sense of self when the system told him he had none, why splitting and stacking firewood mattered as much as any clinical workflow, and how he learned to quiet his "referralologist" training once he joined a Direct Primary Care practice with real time and autonomy. Listeners will hear how DPC reshaped his parenting, his task switching between in-office visits and asynchronous telemedicine, and his perspective on joining an established practice he did not build from scratch.

For any physician who has felt like a charge sheet instead of a clinician, this episode is a reminder: the system does not get to decide your worth, and there is real life after fee-for-service.

In this episode:
How job share became the foundation of a sustainable two-physician family. Why residency training around fee-for-service leaves new physicians blindsided to independent options. What being replaced by a non-physician model does to a person, and how to rebuild. Why rural communities cannot sustain healthcare on a three-day-a-week, hard-to-access model. How Direct Primary Care creates room to practice full scope again and still be present for your kids.

About the guest:
Dr. Jeremiah Fillo is a family physician at Big Trees MD in Arnold, California, where he practices Direct Primary Care alongside Dr. Maryal Concepcion. He trained at Creighton University School of Medicine and completed residency in Modesto, with additional procedural training at Brodstone Memorial in rural Nebraska.

Connect with My DPC Story:
Subscribe wherever you listen, leave a review, and share this episode with a physician who needs to hear that there is a sustainable path forward. Have a question or a story of your own? Call the My DPC Story voicemail and you may hear your answer on a future episode.

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What does it take to make women's healthcare access sustainable, not just for patients, but for the physician carrying the mission? In this episode of the My DPC Story podcast, Dr. Maryal Concepcion welcomes back Dr. Esther Khatibi, family physician who does surgical obstetrics, and founder of My DOC, a nonprofit delivering high-quality, evidence-based obstetric care to women regardless of their social, economic, religious, or ethnic background.

Dr. Khatibi shares how she nearly tanked her own practice caring for pregnant patients who could not afford care anywhere else, and why the answer was not working harder. It was building a coalition: volunteer physicians, a board that believed in her before she had proof, sonographers, grant writers, and donors who each carried part of the load.

This is a conversation about the maternal health gap, why early, individualized prenatal care matters most for the most vulnerable moms, including the higher risk faced by African American women, and why Direct Primary Care doctors are positioned to bring obstetric care back as the share of family physicians doing OB falls from 25 percent to just 7 percent.

What you'll learn:

• How Dr. Khatibi went from nearly tanking her DPC to founding the My DOC nonprofit
• The My DOC model: enrollment for uninsured, underinsured, or high-risk women on the DPC model
• Why early prenatal care reduces maternal morbidity and mortality, especially for African American moms
• How volunteer physicians protect continuity from first visit through delivery and postpartum
• How a 501(c)(3) sends most funds straight to patient services, labs, and ultrasounds
• Why the ER is the wrong place for a pregnant patient, and how a direct line to your doctor helps

Dr. Concepcion and Dr. Khatibi also preview the My DPC Story fireside chats in New Orleans during the DPC Summit, where My DOC and Dr. Emily Holt's Poppy Direct Care come together for women's health access. Only 60 seats.

Links:

• Support My DOC: mydoc.org
• New Orleans Women's Health Fundraiser: mydpcstory.com/upcoming-events
• Support Poppy Direct Care's autoclave fund: https://bit.ly/4oqTS3D
• New to DPC? Start here: mydpcstory.com

Subscribe to My DPC Story on Apple Podcasts and Spotify, and leave a five-star review so more physicians can find these stories.

Stand With Dr. Nyasha Spears and the Future of Patient-Centered Healthcare.

Get your copy of the Physician Owner's Planner today at mydpcstory.com/library

Support the show

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Become A My DPC Story PATREON MEMBER!
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