Many docs who are interested in Direct Primary Care spend a long time in the research phase. I call it "Procrasti-learning." Endlesslessly reading, listening to podcasts, joining groups, trying to figure out where to start, or waiting until everything is "perfect." (that never happens) Because I kept hearing the same questions from physicians who were considering opening a practice, I recently created a small physician cohort called Independent Practice Path. It’s an 8-week program focused on helping physicians move from thinking about opening a Direct Care practice to actively preparing to launch. We focus on things like: • mindset shifts involved in moving from employed physician to owner • learning how to explain the DPC model clearly • where and how to start conversations with potential patients • building early interest in the community • putting basic communication and nurture systems in place • collecting a waitlist of interested patients well before opening day The next cohort starts March 24. If anyone here is considering opening a DPC practice in the next 3-9 months and is curious about it, message me or go to the link here: https://ipp.harmonyopshealth.com/

I built this app in 20 minutes--it's amazing what we can do now! The point of this is to show potential patients the amount of money that they could save with DPC combined with Health Share compared to insurance. Some people need to see it to believe it. https://24-7-bot.harmonyopsfordpc.com/savings

People just starting their DPC journey often ask me for good DPC book recommendations. A few of my favorites are Doug Farrago's books, Julie Gunther's Sparks Start Fires, and Paul Thomas' Startup DPC. I also recommend several business books, too. Dr. Una -EntreMD, Megan DiPietro -She Sells, many others. I've listed them here, along with recommendations for other DPC resources and tech. https://24-7-bot.harmonyopsfordpc.com/dpc-resources Do you have any other great book recommendations for beginning DPC?

What Niches Actually Work Well Inside Direct Primary Care — And Why One of the most common questions I get is: “What niches work best in DPC?” Men’s health. ADHD. Weight loss. Peptides. Hormone optimization. Longevity panels. The question isn’t whether these niches “sell.” The better question is: Do these niches align with the structural strengths of the DPC model? Because DPC is not just a pricing model. It’s an infrastructure model. Certain niches work exceptionally well inside DPC not because they are trendy — but because they require exactly what DPC is designed to deliver: - longitudinal oversight - rapid access - relationship continuity - flexible communication - high-trust decision making Let’s break down why some of these niches fit naturally inside DPC. 1. Men’s Health / Testosterone Optimization This works well inside DPC for one simple reason: It is longitudinal and requires nuance. Testosterone management is not a one-visit prescription event. It requires: - lab monitoring - dose adjustment - symptom interpretation - lifestyle integration - risk stratification In traditional insurance-based primary care, there is rarely time to do this well. Visits are short. Follow-up is fragmented. Messaging is inefficient. DPC solves that. When structured correctly, men’s health becomes: - predictable follow-up - scheduled labs - protocol-based monitoring - defined communication boundaries It fits the model — as long as capacity is engineered. 2. ADHD Management ADHD is another niche that aligns with DPC’s strengths. Why? Because ADHD care requires: - frequent check-ins - medication titration - behavioral discussion - rapid response for side effects - documentation consistency In traditional systems, these patients get lost in the shuffle. Refill friction creates frustration. Follow-up is delayed. In DPC, with structured refill cycles and defined boundaries, ADHD management becomes stable and predictable.

🔥 Capacity Is the Product Direct Primary Care is often described as an access model. It isn’t. It is a capacity model. And the sooner that distinction is understood, the sooner a DPC practice becomes stable, sustainable, and intellectually honest. In traditional insurance-based primary care, physician capacity is fragmented and obscured. The system absorbs inefficiency through layers of bureaucracy, referrals, billing friction, institutional policy, and administrative overhead. There is waste everywhere, but there is also buffering. DPC removes the waste. But it also removes the buffer. What remains is pure capacity. Your time. Your cognitive bandwidth. Your emotional energy. Your boundaries. When a physician launches a DPC clinic, they often ask: How many members can I support? The better question is: How much capacity do I actually have? These are not the same. Capacity is not simply the number of visits you can schedule in a week. Capacity is multi-dimensional and dynamic. It includes: Time Capacity The number of meaningful clinical interactions you can sustain without compressing visits or eroding depth. Cognitive Capacity The number of longitudinal patients you can track without mental spillover — the quiet accumulation of unfinished threads that follow you home. Emotional Capacity The amount of direct-access medicine you can provide before enthusiasm turns into obligation. Boundary Capacity The volume of texts, calls, and asynchronous clinical decisions you can absorb before they begin to create invisible workload. In a DPC model, these dimensions compound. Because in DPC, there is no dilution. There is no RVU-driven fragmentation. There is no system absorbing the overflow. There is no institutional latency to hide inefficiencies. The physician becomes the central processing unit of the system. If that processing unit is not engineered with intention, failure modes are not random. They are predictable. They look like: - Response-time anxiety - Gradual visit compression - The slow expansion of “quick questions” - Text fatigue that is difficult to name - Subtle resentment toward the very access you promised - Burnout inside a model that was supposed to prevent burnout