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/

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.

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.