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If you thought DPC is the only sustainable way to build your cash-pay practice, this episode might offer a different perspective. Dr. Kara Pepper didn’t choose the DPC subscription model or concierge-style access, and yet, patients still line up.

Instead, she created a cash-pay practice built around per-visit pricing—one that gives her patients the freedom to come when they need support. As someone offering very specialized care, she knew her patients might need more attention early on, and she wanted her business to reflect that natural rhythm. She built a structure that’s fair to her patients while also creating space and sustainability for herself.

This episode is for any clinician whose work doesn't fit neatly into the DPC model. If you're offering specialized care, or you're in a niche where the subscription model doesn't feel quite right, you'll walk away from this conversation with a new understanding of what's possible in private-pay practice.

What You’ll Learn

• How Dr. Pepper scaled her cash-pay practice with a per-visit model that supports patient autonomy and protects her energy
 • Why she felt the membership model was not the right fit for her practice
 • How deep relationships built her referral base across 17 states
 • How growing slowly created lasting sustainability
 • Why per-visit pricing works especially well for specialty care

Dr. Kara Pepper

• https://karapeppermd.com/
• https://www.instagram.com/karapeppermd/

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