Under current Medicare rules, a physician who opts out of Medicare for their DPC practice can't bill Medicare anywhere else. That means no hospitalist shifts, no SNF work and no hospice. AAFP Resolution 504, introduced by the New Mexico chapter, asks the AAFP to advocate for a partial opt-out by practice setting. The Congress of Delegates votes on it in October. Dr. Shannon Connolly is co-owner of Open Arms Direct Primary Care in Southern California, a past CAFP president and a CAFP delegate ...

Today a DPC physician in Iowa, 25 months into her DPC practice, emailed us with three decisions she's weighing, and one challenge: "If there are still spots, convince me to come." Challenge accepted. In this mini My DPC Story episode, Drs. Clodagh Ryan and host Maryal Concepcion answer her directly and walk through how the Illinois DPC Summit (open to DPC docs in ALL STATES!) meets each of the three things she's actually asking: "Help me look at the books." Friday morning's session, The Busin...

Dr. Brian Juan toured with rock bands and played dueling piano bars for more than a decade before he became a family doctor. Three months into Metronome Family Medicine, his solo Direct Primary Care practice in Longmont, Colorado, he talks about what it actually took to make the leap. Dr. Brian Juan spent most of his 20s and 30s on the road, first touring with rock and jam bands, then playing dueling pianos in bars around Boulder and Denver. His dad was a Filipino immigrant physician who ran ...

What should a direct primary care physician actually pay themselves? On this episode of My DPC Story, Dr. Maryal Concepcion sits down with Nate Goodman, CPA, founder of Goodman CPA, the accounting firm that works exclusively with direct primary care and direct specialty care practices. Nate is also a DPC patient. His family's experience with direct primary care in the Black Mountains of North Carolina is why his firm stopped taking non-direct care clients in 2024. Together they walk through 1...

Dr. Jillian Klaucke, MD, FAWM. Board-certified family physician at Sandpoint Premier Direct Primary Care, Idaho. Wilderness medicine fellow. Eight years into Direct Primary Care, Dr. Klaucke shares what actually works running a rural family medicine practice without insurance. Her practice runs on three pillars: teamwork, accountability, and patient safety. Teamwork means working with patients as partners. When imaging is needed, someone follows up to confirm it happened. Accountability means...

Dr. Sarai Ambert-Pompey opened Libélula Primary Care in Boise, Idaho. "Libélula" is Spanish for dragonfly, chosen for transformation. One year in, she joins Dr. Maryal Concepcion to talk about what changed when she left the VA for Direct Primary Care. Her path is unconventional: CompUSA and GameStop, Sony PlayStation reviewer training, oncology research at OHSU, then internal medicine residency in Boise. At the VA she joined a Primary Care Center of Excellence and helped launch the Boise Clin...

One month shy of five years. That is how long Big Trees MD ran on the electronic health record it opened with, and this month, that ended. Not because Dr. Maryal Concepcion went looking for something shinier, but because the terms under which her patients' data lived changed, and she could not accept them. In this solo episode, Dr. Concepcion documents the switch in real time from her rural Direct Primary Care practice in Arnold, California, which she owns with her husband, Dr. Jeremiah Fillo...

When Dr. Laura Petrescu opened Athena Direct Primary Care & Lifestyle Medicine, she was the only Direct Primary Care physician in the Rochester, NY metropolitan area. Health system leadership thought she was out of her mind. Colleagues told her nobody would pay a membership on top of insurance. The advice everywhere was the same: New York is too restrictive, and DPC will not work here. Today there are seven or eight DPC practices in the Rochester area, and Dr. Petrescu has founded the New...

Direct Primary Care no longer disqualifies patients from HSA eligibility. As of January 1, 2026, DPC membership fees are a qualified HSA expense at or below $150 per month for one person and $300 for a family. Above $150 you are not in violation. You are in the same gray zone DPC lived in for a decade, and the tax position belongs to the patient and their accountant, not to you. Dr. Phil Eskew (DO, JD, MBA) of DPC Frontier joins Dr. Maryal Concepcion to break down what changed and what it mea...

Dr. Kyle Rickner heard about Direct Primary Care in a side room at the AAFP National Conference in October 2014 and committed to it 50 minutes later. Today Primary Health Partners cares for employee lives in 30 states, and it started with a patient named Jason who owned a 22 person company and handed Dr. Rickner a check covering every employee for a full year, six weeks after opening. In this episode, Dr. Rickner talks with Dr. Maryal Concepcion about what it takes to build a DPC practice tha...