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

CONGRATULATIONS Dr. Oropeza!!!! Learn more about Oropeza Family Health at https://oropezahealth.com/

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

Learn more about Hint Summit at: https://go.hint.com/45zknvf 

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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.

CONGRATULATIONS Dr. Oropeza!!!! Learn more about Oropeza Family Health at https://oropezahealth.com/

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

Learn more about Hint Summit at: https://go.hint.com/45zknvf 

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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.

CONGRATULATIONS Dr. Oropeza!!!! Learn more about Oropeza Family Health at https://oropezahealth.com/

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

Learn more about Hint Summit at: https://go.hint.com/45zknvf 

Support the show

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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.

CONGRATULATIONS Dr. Oropeza!!!! Learn more about Oropeza Family Health at https://oropezahealth.com/

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

Learn more about Hint Summit at: https://go.hint.com/45zknvf 

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CLOSING SOON! VOTE IN THE 2026 MY DPC STORY BATTLE! VOTE HERE

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

CONGRATULATIONS Dr. Oropeza!!!! Learn more about Oropeza Family Health at https://oropezahealth.com/

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

Learn more about Hint Summit at: https://go.hint.com/45zknvf 

Support the show

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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.

Support the show

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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.

CONGRATULATIONS Dr. Oropeza!!!! Learn more about Oropeza Family Health at https://oropezahealth.com/

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

Learn more about Hint Summit at: https://go.hint.com/45zknvf 

Support the show

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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.

CONGRATULATIONS Dr. Oropeza!!!! Learn more about Oropeza Family Health at https://oropezahealth.com/

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

Support the show

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In this June sustainability episode, Maryal sits down with Dr. Daniel Hochman, a psychiatrist in private practice in Texas and the founder of Self Recovery, an online addiction curriculum built from thousands of hours of one-to-one clinical work.

Dr. Hochman left the insurance model early, around 2014, because the deep, philosophical therapy he wanted to practice could never be reimbursed in a fee-for-service system. His definition of sustainability is simple and worth sitting with: work that is aligned with your interests is sustainable, and the drag of burnout shows up when there is interference and conflict instead of alignment.

What you will hear in this episode:

• Why sustainability is about alignment with your interests, not just doing less, and how "slow down" can mean five different things
• His trial-and-error method for building a personal repertoire of recovery tools, using something as ordinary as what you choose to watch at night
• How he protects a sacred solo lunch, eats at his desk, and works calisthenics and movement into the day instead of a separate gym routine
• The honest distinction between what drains him: a suicidal patient that morning did not deplete him, but a misaligned patient asking for a quick fix did
• How he screens for fit by taking every call himself and asking one question: "Are you curious?"
• How to neutrally end or decline a relationship that is not a fit, and why modeling that can itself be therapeutic
• The story behind Self Recovery: why he spent years writing a true addiction curriculum rather than referring patients to subpar options
• His addiction model that became the course structure: emotional pain leads to craving, craving to following through, following through to false pleasure, with a capstone on how to actually live
• Why an educational designer helped him break heavy material into digestible, story-driven modules that keep people asking "what's next"
• Why online, private, self-paced work helps people face their hardest material when they are ready, on their own time
• A one-minute motivational interviewing technique any physician can memorize: "On a scale of zero to 10, how ready are you to change?" then "Why not higher, and why not lower?"
• The tool most physicians leave on the table in addiction care, and how to pitch it as helping a patient be accountable to their own better half
• His incremental, no-big-scary-beast advice for physicians who feel stuck but are not yet a 10 out of 10 ready to make the leap

Connect with Dr. Hochman:

• Self Recovery (online addiction curriculum, direct to consumer)
• The Zanko Method, a curriculum for professionals living with addiction.
• One-day Intensives at his practice: hochmanhealth.com (see the Intensives tab)

New to DPC? Head to the Start Here page at mydpcstory.com for a practical startup guide and the essential beginner episodes.

Got a question for the show? Leave a voice message on the contact page at mydpcstory.com.

Want commercial-free and extended episodes? Join the My DPC Story Patreon.

Follow along @mydpcstory and find everything at mydpcstory.com.

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

CONGRATULATIONS Dr. Oropeza!!!! Learn more about Oropeza Family Health at https://oropezahealth.com/

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

Learn more about Hint Summit at: https://go.hint.com/45zknvf 

Support the show

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Can Direct Primary Care really pay off for a physician family carrying student loan debt and no employer match? In this episode of the My DPC Story podcast, host Dr. Maryal Concepcion talks with Dr. Manuel Vogt of Texas DPC about the real financial tools behind building a thriving practice.

From a billboard at a railroad crossing to a 220-patient pre-enrollment list on opening day, Dr. Vogt shares how he and his wife built two separate Direct Primary Care clinics in San Antonio while protecting each other's autonomy. The standout story: how they used federal and state historic preservation tax credits, ADA credits, and a solar carport credit to fund a clinic renovation, then sold the state credits for 93 cents on the dollar.

In this episode you'll learn:

• How a physician couple runs two independent DPC practices as a family
• Using historic tax credits to fund a clinic renovation
• Subleasing clinic space to cover your entire overhead
• Marketing to employers through a multi-clinic DPC umbrella
• A workaround for Texas dispensing laws and discounted wholesale labs
• Better diabetes care with CGMs and same-day texting
• Finding the panel size (around 500) that supports a daily 5K and school pickups
• A pricing strategy that raises rates without losing patients
• Advocacy priorities: in-office dispensing and FSA eligibility

Whether you are a resident exploring Direct Primary Care or an established DPC owner planning expansion, this conversation is full of practical, money-saving ideas.

🔗 Vote in the Battle of the Support Stack and explore more at mydpcstory.com 🤝 Advocate with the Direct Primary Care Coalition at dpcare.org 💛 Join the My DPC Story Patreon for exclusive content

Subscribe and follow My DPC Story for new episodes every week. If this helped, please leave a review to help others find the show.

#DirectPrimaryCare #DPC #TexasDPC #MyDPCStory #PhysicianEntrepreneur #FamilyMedicine #HealthcareRenovation

CONGRATULATIONS Dr. Oropeza!!!! Learn more about Oropeza Family Health at https://oropezahealth.com/

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

Learn more about Hint Summit at: https://go.hint.com/45zknvf 

Support the show

GET your FREE MONTHLY BUSINESS TOOL DOWNLOAD

Become A My DPC Story PATREON MEMBER!
SPONSOR THE POD
My DPC Story VOICEMAIL! DPC SWAG!
FACEBOOK * INSTAGRAM * LinkedIn * TWITTER * TIKTOK * YouTube