Why We Built This — And Why We Never Quit
What pushed us to build something different wasn’t a business idea.
It was what we were seeing every day in the emergency department.
A huge number of patients who come through the ER are there for one simple reason: they don’t have access to primary care. Not because they made poor decisions. Not because they didn’t care. Simply because access didn’t exist.
Some arrive poorly treated—not from neglect, but from delay. Others wait four, five, sometimes six hours in an emergency department for minor illnesses that could have been handled safely and efficiently through telemedicine if access were available.
That stayed with us.
We weren’t trying to replace emergency medicine. We were trying to protect it—by keeping patients out of the ER when they didn’t need to be there, and by creating an economical, accessible way for people to get care earlier.
From the beginning, we knew Direct Primary Care was the direction we wanted to go. But we also knew access alone wasn’t enough. Telemedicine had to be part of the solution.
Not as a shortcut.
Not as a replacement for real care.
But as a way to remove unnecessary friction.
We don’t believe doctors are “getting it wrong.” Most are overwhelmed—buried under red tape, documentation, and systems that make meaningful care harder every year. The intent is there. The time is not.
At the same time, both of us were still working roughly 150 hours a month in the emergency department. We were very intentional about keeping those worlds separate. As tempting as it might have been from a business standpoint, we never pitched our clinic to patients in the ER. That line mattered to us.
We wanted this built the right way—or not at all.
There are plenty of colleagues who think we’re crazy for taking this path. That’s fine. What’s driven us hasn’t changed: an undying drive not just to be successful, but to create something better.
Staying clinically grounded has always mattered. Emergency medicine keeps you honest. It also makes it clear that better access and longer appointments create space—for conversation, for prevention, and for alternatives before defaulting to the usual pharmaceutical path.
We were grounded in medicine.
But we also knew medicine could be practiced differently.
And that belief is where everything else started.
What We Got Wrong (And What It Taught Us)
There wasn’t one big operational mistake.
There was something harder: we had a lot to learn.
Early on, we made a conscious decision to jump in and build—doing what we knew best at the time, which was working hard and taking care of patients. What we didn’t yet understand was how much systems matter when you’re trying to deliver superior care consistently.
Ironically, the thing that broke most often was our desire to do right by patients.
Patients were the ones reminding us:
- It’s been four months—when should labs be drawn?
- Six months—weren’t we supposed to recheck this?
- Did you see my results come back?
We weren’t automated. Results came in, but there was no reliable mechanism to notify us. Follow-up depended on memory, manual tracking, or the patient reaching out again. That wasn’t acceptable—but it was our reality early on.
The most frustrating issue for patients—and the one that forced us to change—was billing visibility. Patients were on membership plans, but if a payment failed, we often didn’t know. Months would go by. Then we’d discover it and have to reach out asking for two or three months of missed payments.
That eroded trust, and we knew it.
Fixing that became non-negotiable.
Over the last six months, we’ve leaned heavily into automation using GoHighLevel as our CRM. That shift has been eye-opening. There are countless ways to improve communication, follow-up, billing transparency, and internal workflows—things that reduce friction for patients and burnout for providers.
We also learned that pricing clarity matters. We changed prices multiple times—probably half a dozen. Early on, our pricing was complicated. Over time, we realized that in Direct Primary Care, complexity creates confusion. Simplifying pricing created clarity—and clarity builds trust.
Losing patients was one of the hardest parts. It felt personal. We got into this to take care of people the right way, and we wanted them to stay with us long-term. But we also had to be honest: early on, we weren’t always delivering exactly what we promised.
Technology taught us that lesson too. We initially used an EMR with Zoom built in. It made sense to us—we were familiar with Zoom. But many patients weren’t. They didn’t have the app. They struggled to connect. And we didn’t yet have a process to help them through it. Small barriers created big frustration.
Growth forced harder decisions.
About 18 months in, we opened a clinic in Missouri after finding the right practitioner to serve a truly underserved area. That move made something clear: our original name no longer fit our vision.
Emerald Coast Concierge Medicine meant something to us. It’s where we started. But it didn’t resonate beyond the Florida panhandle. We weren’t building a local experiment anymore—we were building something that needed to make sense nationally.
Today, we’re caring for patients in 22 states.
What We Got Wrong About Marketing
One of the most important lessons we learned—later than we should have—was about marketing.
Early on, we tried to advertise too soon. We ran Facebook ads. We worked with fly-by-night marketing agencies that promised fast growth and “patients through the door.”
What we didn’t understand yet was this:
Marketing without trust doesn’t scale care—it exposes your weaknesses.
We were asking patients to believe in something we hadn’t fully operationalized yet. We hadn’t perfected systems. We hadn’t fully aligned workflows. We hadn’t earned trust at scale.
What we’ve learned since is simple but critical:
- Trust comes first
- Trust takes time
- Trust is built by doing things the right way—consistently
Only after you can reliably take exceptional care of patients does advertising make sense.
Pouring into growth before you’re ready to care for the people who respond may be the single biggest mistake a clinic can make.
In late spring, we partnered with Anton Neugebauer of Real Advice Agency, who has been instrumental in teaching us this. Anton is also the GoHighLevel expert we referenced earlier, and he helped us understand how automation, messaging, and marketing all have to align around trust—not speed.
That partnership marked a turning point.
Why We Never Quit
If there’s one reason we never walked away, it’s this: family comes first.
For both of us, setting an example for our kids matters deeply—even though our kids are in very different stages of life. There’s a powerful lesson in letting them see when things are hard and talking openly about it.
Not to complain.
Not to dramatize.
But to show them that difficulty doesn’t equal defeat.
We wanted them to understand that while quitting is always an option, it’s not one we take lightly. When we start something—especially something that matters—we don’t walk away from it when it gets uncomfortable.
At its core, this practice has always been about patients.
Emergency medicine gives you incredible experiences, but it doesn’t allow you to walk alongside people through their entire journey. You stabilize them. You help them survive. Then they move on.
We wanted continuity.
We wanted relationship.
We wanted to see what happens when people are actually given time, access, and hope.
Giving people hope is a form of leadership.
We see patients every day who are at the end of their rope—men with low testosterone who’ve lost their drive and energy and are ready to give up; patients who’ve been told, implicitly or explicitly, that this is “just how it is now.”
When you have longer appointments—when you can truly listen—you can show people there is something better.
Why This Story Isn’t Finished
Saying this story isn’t finished isn’t a marketing line.
It’s a philosophy.
As husbands, fathers, and doctors, we believe there is always room to get better. This clinic mirrors our lives in that way—always evolving, always improving.
Continuing to work full time in the emergency department has been intentional. It’s allowed us to build without business loans, without bank pressure, and without private equity dictating direction.
It’s also made us better clinicians.
Emergency medicine sharpens judgment and pattern recognition—skills that translate directly into telemedicine and continuity care. We’ve already seen cases where that grounding made a real difference.
Working in the ER also forced us to understand healthcare deeply—its rules, its failures, its distortions. Along the way, we learned about medical cost sharing and alternative solutions we never fully understood before. That knowledge now helps us guide patients who are looking for something more human.
Who This Story Is For:
This story is for physicians who are tired.
For hospitalists.
For ER doctors.
For clinicians grinding inside systems that don’t give them room to practice the way they know they should.
We want them to know this:
You can build something better.
Not overnight.
Not without mistakes.
Not without stress.
But if you keep moving forward—if you stay honest and patient—you can make it work.
This isn’t unique.
We’re not trying to corner the market.
There are plenty of patients to go around.
If this story helps even one physician believe they can create something aligned with their values, then telling it is worth it.
And that’s why we’re still here.
Key Lessons We’ve Learned Along the Way
- Access is the problem before anything else.Most patients don’t end up in the ER because they want to—they end up there because they can’t get timely primary care. Fix access first.
- Telemedicine works best when it’s part of a larger care model.Virtual care isn’t a shortcut; it’s a tool. When combined with continuity and clear follow-up, it meaningfully improves care.
- Good intentions don’t replace systems.Wanting to take excellent care of patients isn’t enough. Automation, reminders, and workflows protect both patients and providers.
- Billing clarity is trust.If patients don’t understand what they’re paying—or if surprises appear later—trust erodes quickly. Transparency isn’t optional.
- Simple pricing beats clever pricing.Complexity creates confusion. Clear, straightforward pricing helps patients feel confident in their decision.
- Losing patients hurts—but it teaches you the truth.Early departures forced us to confront where we weren’t delivering what we promised. Growth requires honesty.
- Technology should reduce friction, not create it.If patients can’t connect easily, care breaks down. Every tool has to work for them, not just for us.
- Marketing before trust exposes weaknesses.Advertising too early doesn’t grow a practice—it magnifies its gaps. Trust has to come first.
- Systems make growth sustainable.Working harder isn’t scalable. The right systems allow care to improve as the practice grows.
- Staying clinically grounded matters.Continuing to work in the ER keeps perspective sharp and reinforces why better primary care is needed.
- Family is the ultimate compass.Building something meaningful means modeling perseverance, honesty, and balance for the people watching us most closely.
- Giving people hope is real medicine.Time, access, and listening often change outcomes before a prescription ever does.
- This model is repeatable.Nothing about this journey is unique. With patience, humility, and persistence, others can build something better too.
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Why We Built This — And Why We Never Quit
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Direct primary care gives unlimited access to your doctor, same-day visits, clear pricing, and no insurance—medicine built on trust.
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